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
derivation: constraint
name: CompositionPSON
type: Composition
elements:
  category:
    mustSupport: true
    index: 8
    extensions:
      ext-LOINC-ontology-axis:
        url: http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis
        type: Extension
        isModifier: false
        index: 9
        elements:
          url:
            pattern: {type: Uri, value: 'http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis'}
            index: 10
    elements:
      extension:
        type: Extension
        isModifier: false
        url: http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis
        index: 9
        slicing:
          slices:
            ext-LOINC-ontology-axis:
              match: {}
              schema:
                type: Extension
                isModifier: false
                url: http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis
                index: 9
                elements:
                  url:
                    pattern: {type: Uri, value: 'http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis'}
                    index: 10
      coding:
        mustSupport: true
        index: 11
        elements:
          system: {mustSupport: true, index: 12}
          code: {mustSupport: true, index: 13}
          display: {mustSupport: true, index: 14}
    slicing:
      rules: open
      discriminator:
      - {path: $this, type: pattern}
      min: null
      slices:
        sliceCategory-type-of-service:
          match: {}
          schema:
            mustSupport: true
            index: 15
            extensions:
              ext-LOINC-ontology-axis:
                url: http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis
                type: Extension
                isModifier: false
                mustSupport: true
                index: 17
                elements:
                  url:
                    pattern: {type: Uri, value: 'http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis'}
                    index: 18
                  value[x]:
                    elements:
                      code: {index: 19}
                      display: {index: 20}
            elements:
              extension:
                index: 16
                slicing:
                  slices:
                    ext-LOINC-ontology-axis:
                      match: {}
                      schema:
                        type: Extension
                        isModifier: false
                        mustSupport: true
                        url: http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis
                        index: 17
                        elements:
                          url:
                            pattern: {type: Uri, value: 'http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis'}
                            index: 18
                          value[x]:
                            elements:
                              code: {index: 19}
                              display: {index: 20}
              coding:
                mustSupport: true
                index: 21
                elements:
                  system:
                    pattern: {type: Uri, value: 'http://loinc.org'}
                    mustSupport: true
                    index: 22
                  code: {mustSupport: true, index: 23}
                  display:
                    pattern: {type: String, value: Patient summary}
                    mustSupport: true
                    index: 24
                required: [display, system, code]
            required: [extension, coding]
        sliceCategory-kind-of-document:
          match: {}
          schema:
            mustSupport: true
            index: 25
            extensions:
              ext-LOINC-ontology-axis:
                url: http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis
                type: Extension
                isModifier: false
                mustSupport: true
                index: 27
                elements:
                  url:
                    pattern: {type: Uri, value: 'http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis'}
                    index: 28
                  value[x]:
                    elements:
                      code: {index: 29}
                      display: {index: 30}
            elements:
              extension:
                index: 26
                slicing:
                  slices:
                    ext-LOINC-ontology-axis:
                      match: {}
                      schema:
                        type: Extension
                        isModifier: false
                        mustSupport: true
                        url: http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis
                        index: 27
                        elements:
                          url:
                            pattern: {type: Uri, value: 'http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis'}
                            index: 28
                          value[x]:
                            elements:
                              code: {index: 29}
                              display: {index: 30}
              coding:
                mustSupport: true
                index: 31
                elements:
                  system:
                    pattern: {type: Uri, value: 'http://loinc.org'}
                    mustSupport: true
                    index: 32
                  code:
                    pattern: {type: Code, value: LP173418-7}
                    mustSupport: true
                    index: 33
                  display:
                    pattern: {type: String, value: Note}
                    mustSupport: true
                    index: 34
                required: [display, system, code]
            required: [extension, coding]
        sliceCategory-subject-matter-domain:
          match: {}
          schema:
            mustSupport: true
            index: 35
            extensions:
              ext-LOINC-ontology-axis:
                url: http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis
                type: Extension
                isModifier: false
                mustSupport: true
                index: 37
                elements:
                  url:
                    pattern: {type: Uri, value: 'http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis'}
                    index: 38
                  value[x]:
                    elements:
                      code: {index: 39}
                      display: {index: 40}
            elements:
              extension:
                index: 36
                slicing:
                  slices:
                    ext-LOINC-ontology-axis:
                      match: {}
                      schema:
                        type: Extension
                        isModifier: false
                        mustSupport: true
                        url: http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis
                        index: 37
                        elements:
                          url:
                            pattern: {type: Uri, value: 'http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis'}
                            index: 38
                          value[x]:
                            elements:
                              code: {index: 39}
                              display: {index: 40}
              coding:
                mustSupport: true
                index: 41
                elements:
                  system:
                    pattern: {type: Uri, value: 'http://loinc.org'}
                    mustSupport: true
                    index: 42
                  code:
                    pattern: {type: Code, value: CGTA1009-1}
                    mustSupport: true
                    index: 43
                  display:
                    pattern: {type: String, value: Unspecified}
                    mustSupport: true
                    index: 44
                required: [display, system, code]
            required: [extension, coding]
        sliceCategory-role:
          match: {}
          schema:
            index: 45
            extensions:
              ext-LOINC-ontology-axis:
                url: http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis
                type: Extension
                isModifier: false
                mustSupport: true
                index: 47
                elements:
                  url:
                    pattern: {type: Uri, value: 'http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis'}
                    index: 48
                  value[x]:
                    elements:
                      code: {index: 49}
                      display: {index: 50}
            elements:
              extension:
                index: 46
                slicing:
                  slices:
                    ext-LOINC-ontology-axis:
                      match: {}
                      schema:
                        type: Extension
                        isModifier: false
                        mustSupport: true
                        url: http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis
                        index: 47
                        elements:
                          url:
                            pattern: {type: Uri, value: 'http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis'}
                            index: 48
                          value[x]:
                            elements:
                              code: {index: 49}
                              display: {index: 50}
              coding:
                mustSupport: true
                index: 51
                elements:
                  system:
                    pattern: {type: Uri, value: 'http://loinc.org'}
                    mustSupport: true
                    index: 52
                  code:
                    pattern: {type: Code, value: CGTA4001-1}
                    mustSupport: true
                    index: 53
                  display:
                    pattern: {type: String, value: Unspecified}
                    mustSupport: true
                    index: 54
                required: [display, system, code]
            required: [extension, coding]
        sliceCategory-setting:
          match: {}
          schema:
            mustSupport: true
            index: 55
            extensions:
              ext-LOINC-ontology-axis:
                url: http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis
                type: Extension
                isModifier: false
                mustSupport: true
                index: 57
                elements:
                  url:
                    pattern: {type: Uri, value: 'http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis'}
                    index: 58
            elements:
              extension:
                index: 56
                slicing:
                  slices:
                    ext-LOINC-ontology-axis:
                      match: {}
                      schema:
                        type: Extension
                        isModifier: false
                        mustSupport: true
                        url: http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis
                        index: 57
                        elements:
                          url:
                            pattern: {type: Uri, value: 'http://ontariohealth.ca/fhir/StructureDefinition/ext-loinc-ontology-axis'}
                            index: 58
              coding:
                mustSupport: true
                index: 59
                elements:
                  system:
                    pattern: {type: Uri, value: 'http://loinc.org'}
                    mustSupport: true
                    index: 60
                  code:
                    pattern: {type: Code, value: CGTA5001-1}
                    mustSupport: true
                    index: 61
                  display:
                    pattern: {type: String, value: Unspecified}
                    mustSupport: true
                    index: 62
                required: [display, system, code]
            required: [extension, coding]
  date: {mustSupport: true, index: 66}
  meta:
    mustSupport: true
    index: 0
    elements:
      profile: {mustSupport: true, index: 1}
    required: [profile]
  encounter: {index: 65}
  section:
    short: Sections composing the PS
    mustSupport: true
    index: 83
    elements:
      code:
        type: CodeableConcept
        mustSupport: true
        index: 84
        elements:
          coding:
            elements:
              display:
                extensions:
                  translation:
                    url: null
                    index: 85
                    elements:
                      url:
                        pattern: {type: Uri, value: translation}
                        index: 86
                elements:
                  extension:
                    index: 85
                    slicing:
                      slices:
                        translation:
                          match: {}
                          schema:
                            index: 85
                            elements:
                              url:
                                pattern: {type: Uri, value: translation}
                                index: 86
      text: {mustSupport: true, index: 87}
    required: [text, code]
    slicing:
      rules: open
      ordered: false
      discriminator:
      - {path: code, type: pattern}
      min: 1
      slices:
        sectionMedications:
          match:
            code:
              coding:
              - {code: 10160-0, system: 'http://loinc.org'}
          schema:
            short: PS-ON Medication Summary Section
            mustSupport: true
            _required: true
            index: 88
            elements:
              title: {short: Medication Summary section, mustSupport: true, index: 89}
              code:
                mustSupport: true
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 10160-0, system: 'http://loinc.org'}
                index: 90
              text: {mustSupport: true, index: 91}
              entry:
                short: Medications relevant for the scope of the patient summary
                mustSupport: true
                index: 92
                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: 93
                      min: 1
              emptyReason: {mustSupport: false, index: 94}
              section: {mustSupport: false, index: 95}
            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: 96
            elements:
              title: {mustSupport: true, index: 97}
              code:
                mustSupport: true
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 48765-2, system: 'http://loinc.org'}
                index: 98
              text: {mustSupport: true, index: 99}
              entry:
                short: Relevant allergies or intolerances (conditions) for that patient.
                mustSupport: true
                index: 100
                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: 101
                      min: 1
              emptyReason: {mustSupport: false, index: 102}
              section: {mustSupport: false, index: 103}
            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: 104
            elements:
              title: {mustSupport: true, index: 105}
              code:
                mustSupport: true
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 11450-4, system: 'http://loinc.org'}
                index: 106
              text: {mustSupport: true, index: 107}
              entry:
                short: Clinical problems or conditions currently being monitored for the patient.
                mustSupport: true
                index: 108
                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: 109
                      min: 1
              emptyReason: {mustSupport: false, index: 110}
              section: {mustSupport: false, index: 111}
            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: 112
            elements:
              title: {mustSupport: true, index: 113}
              code:
                mustSupport: true
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 47519-4, system: 'http://loinc.org'}
                index: 114
              text: {mustSupport: true, index: 115}
              entry:
                short: Patient past procedures pertinent to the scope of this document.
                mustSupport: true
                index: 116
                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: 117
                      min: 1
              emptyReason: {mustSupport: false, index: 118}
              section: {mustSupport: false, index: 119}
            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: 120
            elements:
              title: {mustSupport: true, index: 121}
              code:
                mustSupport: true
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 11369-6, system: 'http://loinc.org'}
                index: 122
              text: {mustSupport: true, index: 123}
              entry:
                short: Patient's immunization status and pertinent history.
                mustSupport: true
                index: 124
                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: 125
                      min: 1
              emptyReason: {mustSupport: false, index: 126}
              section: {mustSupport: false, index: 127}
            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: 128
            elements:
              title: {mustSupport: true, index: 129}
              code:
                mustSupport: true
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 11348-0, system: 'http://loinc.org'}
                index: 130
              text: {mustSupport: true, index: 131}
              entry:
                short: Conditions the patient suffered in the past.
                mustSupport: true
                index: 132
                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: 133
                      min: 1
              emptyReason: {mustSupport: false, index: 134}
              section: {mustSupport: false, index: 135}
            required: [entry, text, title, code]
  attester:
    mustSupport: true
    index: 71
    elements:
      mode: {mustSupport: true, index: 72}
      time: {mustSupport: true, index: 73}
      party:
        type: Reference
        mustSupport: true
        refers: ['http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-organization', 'http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-practitionerrole']
        index: 74
    required: [party]
  type:
    short: Kind of composition ("Patient Summary")
    mustSupport: true
    pattern:
      type: CodeableConcept
      value:
        coding:
        - {code: 60591-5, system: 'http://loinc.org'}
    index: 7
  title: {short: Ontario Patient Summary, mustSupport: true, index: 70}
  author:
    short: Who and/or what authored the patient summary
    mustSupport: true
    index: 67
    slicing:
      rules: open
      discriminator:
      - {path: resolve(), type: profile}
      min: null
      slices:
        authorPSON:
          match: {}
          schema:
            type: Reference
            short: Who and/or what authored the patient summary
            mustSupport: true
            refers: ['http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-organization', 'http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-practitionerrole']
            index: 68
        DevicePSON:
          match: {}
          schema:
            type: Reference
            short: Who and/or what authored the patient summary
            mustSupport: true
            refers: ['http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-device']
            index: 69
  event:
    index: 76
    slicing:
      rules: open
      discriminator:
      - {path: code, type: pattern}
      min: null
      slices:
        careProvisioningEvent:
          match:
            code:
              coding:
              - {code: PCPR, system: 'http://terminology.hl7.org/CodeSystem/v3-ActClass'}
          schema:
            short: The care provisioning being documented
            index: 77
            elements:
              code:
                mustSupport: true
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: PCPR, system: 'http://terminology.hl7.org/CodeSystem/v3-ActClass'}
                index: 78
                elements:
                  coding:
                    index: 79
                    elements:
                      system:
                        pattern: {type: Uri, value: 'http://terminology.hl7.org/CodeSystem/v3-ActClass'}
                        index: 80
                      code:
                        pattern: {type: Code, value: PCPR}
                        index: 81
                    required: [system, code]
                required: [coding]
              period: {mustSupport: true, index: 82}
            required: [code]
  custodian:
    type: Reference
    mustSupport: true
    refers: ['http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-organization']
    index: 75
  status: {mustSupport: true, index: 6}
  identifier:
    mustSupport: true
    index: 3
    elements:
      system: {mustSupport: true, index: 4}
      value: {mustSupport: true, index: 5}
    required: [value, system]
  subject:
    type: Reference
    mustSupport: true
    refers: ['http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-patient']
    index: 63
    elements:
      reference: {mustSupport: true, index: 64}
    required: [reference]
  text: {mustSupport: true, index: 2}
package_version: summary-0.12.3
class: profile
kind: resource
url: http://ontariohealth.ca/fhir/StructureDefinition/ca-on-ps-profile-composition
base: http://hl7.org/fhir/StructureDefinition/Composition
version: 0.12.0
required: [attester, section, identifier, subject, meta, custodian]