description: Profile for hospital discharge reports in the Irish healthcare system, aligned with the HL7 Europe Hospital Discharge Report IG (hl7.fhir.eu.hdr) and the Xt-EHR EHDSDischargeReport logical model v1.0.0. Structures the essential clinical information communicated at the point of hospital discharge. The 1.0.0 model significantly expands the structure to include admission evaluation, patient history (anamnesis), course of encounter, discharge details, and attachments.
package_name: nostalgic-ie.fhir.core
derivation: constraint
name: IECoreCompositionDischargeReport
type: Composition
elements:
  date: {mustSupport: true, index: 4}
  encounter:
    type: Reference
    short: The hospital encounter being discharged from
    mustSupport: true
    refers: ['https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-encounter']
    index: 3
  section:
    array: true
    min: 2
    index: 8
    slicing:
      rules: open
      discriminator:
      - {path: code, type: pattern}
      min: 2
      slices:
        encounterInformation:
          match:
            code:
              coding:
              - {code: 46241-6, system: 'http://loinc.org', display: Hospital admission diagnosis Narrative - Reported}
          schema:
            short: Encounter information — admission and discharge dates, reason for admission (mandatory)
            mustSupport: true
            _required: true
            index: 9
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 46241-6, system: 'http://loinc.org', display: Hospital admission diagnosis Narrative - Reported}
                index: 10
              text: {mustSupport: true, index: 11}
              entry:
                type: Reference
                mustSupport: true
                refers: ['https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-encounter']
                index: 12
            required: [code]
        courseOfEncounter:
          match:
            code:
              coding:
              - {code: 8648-8, system: 'http://loinc.org', display: Hospital course note}
          schema:
            short: Course of encounter — diagnoses, procedures, medications, and key results (mandatory)
            mustSupport: true
            _required: true
            index: 13
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 8648-8, system: 'http://loinc.org', display: Hospital course note}
                index: 14
              text: {mustSupport: true, index: 15}
              entry: {mustSupport: true, index: 16}
              section:
                index: 17
                slicing:
                  rules: open
                  discriminator:
                  - {path: code, type: pattern}
                  min: null
                  slices:
                    diagnoses:
                      match:
                        code:
                          coding:
                          - {code: 11535-2, system: 'http://loinc.org', display: Hospital discharge diagnosis note}
                      schema:
                        type: BackboneElement
                        short: Discharge diagnoses (EHDSCondition)
                        mustSupport: true
                        index: 18
                        elements:
                          code:
                            pattern:
                              type: CodeableConcept
                              value:
                                coding:
                                - {code: 11535-2, system: 'http://loinc.org', display: Hospital discharge diagnosis note}
                            index: 19
                          entry:
                            type: Reference
                            mustSupport: true
                            refers: ['https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-condition-encounter-diagnosis']
                            index: 20
                        required: [code]
                    procedures:
                      match:
                        code:
                          coding:
                          - {code: 47519-4, system: 'http://loinc.org', display: History of Procedures Document}
                      schema:
                        type: BackboneElement
                        short: Procedures performed during encounter
                        mustSupport: true
                        index: 21
                        elements:
                          code:
                            pattern:
                              type: CodeableConcept
                              value:
                                coding:
                                - {code: 47519-4, system: 'http://loinc.org', display: History of Procedures Document}
                            index: 22
                          entry:
                            type: Reference
                            mustSupport: true
                            refers: ['https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-procedure']
                            index: 23
                        required: [code]
                    pharmacotherapy:
                      match:
                        code:
                          coding:
                          - {code: 10160-0, system: 'http://loinc.org', display: History of Medication use Narrative}
                      schema:
                        type: BackboneElement
                        short: Significant pharmacotherapy during encounter (EHDSMedicationUse)
                        mustSupport: true
                        index: 24
                        elements:
                          code:
                            pattern:
                              type: CodeableConcept
                              value:
                                coding:
                                - {code: 10160-0, system: 'http://loinc.org', display: History of Medication use Narrative}
                            index: 25
                          entry:
                            type: Reference
                            mustSupport: true
                            refers: ['https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-medicationrequest', 'https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-medicationrequest-eprescription', 'https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-medicationstatement']
                            index: 26
                        required: [code]
                    testResults:
                      match:
                        code:
                          coding:
                          - {code: 30954-2, system: 'http://loinc.org', display: Relevant diagnostic tests/laboratory data note}
                      schema:
                        type: BackboneElement
                        short: Significant test results during encounter
                        mustSupport: true
                        index: 27
                        elements:
                          code:
                            pattern:
                              type: CodeableConcept
                              value:
                                coding:
                                - {code: 30954-2, system: 'http://loinc.org', display: Relevant diagnostic tests/laboratory data note}
                            index: 28
                          entry:
                            type: Reference
                            mustSupport: true
                            refers: ['https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-diagnosticreport-lab', 'https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-laboratory-result-observation', 'https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-observation-clinical-result']
                            index: 29
                        required: [code]
            required: [code]
        admissionEvaluation:
          match:
            code:
              coding:
              - {code: 57852-6, system: 'http://loinc.org', display: Problem list Narrative - Reported}
          schema:
            short: Admission evaluation — objective findings and functional status at admission
            mustSupport: true
            index: 30
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 57852-6, system: 'http://loinc.org', display: Problem list Narrative - Reported}
                index: 31
              text: {mustSupport: true, index: 32}
              entry:
                type: Reference
                mustSupport: true
                refers: ['https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-condition-problems-health-concerns', 'https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-observation-clinical-result', 'https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-simple-observation']
                index: 33
            required: [code]
        patientHistory:
          match:
            code:
              coding:
              - {code: 11329-0, system: 'http://loinc.org', display: History general Narrative - Reported}
          schema:
            short: Patient health history (anamnesis) relevant to this episode of care
            mustSupport: true
            index: 34
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 11329-0, system: 'http://loinc.org', display: History general Narrative - Reported}
                index: 35
              text: {mustSupport: true, index: 36}
              entry:
                type: Reference
                mustSupport: true
                refers: ['https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-condition-encounter-diagnosis', 'https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-condition-problems-health-concerns', 'https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-implantable-device', 'https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-procedure']
                index: 37
            required: [code]
        dischargeDetails:
          match:
            code:
              coding:
              - {code: 8650-4, system: 'http://loinc.org', display: Hospital discharge disposition note}
          schema:
            short: Discharge details — objective findings and functional status at discharge
            mustSupport: true
            index: 38
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 8650-4, system: 'http://loinc.org', display: Hospital discharge disposition note}
                index: 39
              text: {mustSupport: true, index: 40}
              entry:
                type: Reference
                mustSupport: true
                refers: ['https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-observation-clinical-result', 'https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-simple-observation']
                index: 41
            required: [code]
        alerts:
          match:
            code:
              coding:
              - {code: 104605-1, system: 'http://loinc.org', display: Alert}
          schema:
            short: Alerts — substantial medical alerts or warnings (EHDSAlert)
            mustSupport: true
            index: 42
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 104605-1, system: 'http://loinc.org', display: Alert}
                index: 43
              text: {mustSupport: true, index: 44}
              entry:
                type: Reference
                mustSupport: true
                refers: ['https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-allergyintolerance', 'https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-flag']
                index: 45
            required: [code]
        medicationSummary:
          match:
            code:
              coding:
              - {code: 75311-1, system: 'http://loinc.org', display: Discharge medications note}
          schema:
            short: Discharge medications (EHDSMedicationUse)
            mustSupport: true
            index: 46
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 75311-1, system: 'http://loinc.org', display: Discharge medications note}
                index: 47
              text: {mustSupport: true, index: 48}
              entry:
                type: Reference
                mustSupport: true
                refers: ['https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-medicationrequest', 'https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-medicationrequest-eprescription', 'https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-medicationstatement']
                index: 49
            required: [code]
        carePlan:
          match:
            code:
              coding:
              - {code: 18776-5, system: 'http://loinc.org', display: Plan of care note}
          schema:
            short: Post-discharge care plan and follow-up recommendations
            mustSupport: true
            index: 50
            elements:
              code:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: 18776-5, system: 'http://loinc.org', display: Plan of care note}
                index: 51
              text: {mustSupport: true, index: 52}
              entry:
                type: Reference
                mustSupport: true
                refers: ['https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-careplan', 'https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-servicerequest']
                index: 53
            required: [code]
  type:
    mustSupport: true
    pattern:
      type: CodeableConcept
      value:
        coding:
        - {code: 18842-5, system: 'http://loinc.org', display: Discharge summary}
    index: 1
  title: {short: Hospital Discharge Report, mustSupport: true, index: 6}
  author:
    type: Reference
    mustSupport: true
    refers: ['https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-organization', 'https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-practitioner', 'https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-practitionerrole']
    index: 5
  custodian:
    type: Reference
    mustSupport: true
    refers: ['https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-organization']
    index: 7
  status: {mustSupport: true, index: 0}
  subject:
    type: Reference
    mustSupport: true
    refers: ['https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-patient']
    index: 2
package_version: 0.2.0
class: profile
kind: resource
url: https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-composition-discharge-report
base: http://hl7.org/fhir/StructureDefinition/Composition
version: 0.2.0
required: [encounter, subject]