{
  "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.",
  "_filename": "StructureDefinition-ie-core-composition-discharge-report.json",
  "package_name": "nostalgic-ie.fhir.core",
  "date": null,
  "derivation": "constraint",
  "publisher": null,
  "fhirVersion": "4.0.1",
  "name": "IECoreCompositionDischargeReport",
  "abstract": false,
  "type": "Composition",
  "experimental": null,
  "resourceType": "StructureDefinition",
  "title": "IE Core Composition (Hospital Discharge Report)",
  "package_version": "0.2.0",
  "status": "draft",
  "id": "f4edaf26-cfc7-43ae-978c-68f4c3bef101",
  "kind": "resource",
  "url": "https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-composition-discharge-report",
  "version": "0.2.0",
  "differential": {
    "element": [ {
      "id": "Composition.status",
      "path": "Composition.status",
      "mustSupport": true
    }, {
      "id": "Composition.type",
      "path": "Composition.type",
      "mustSupport": true,
      "patternCodeableConcept": {
        "coding": [ {
          "code": "18842-5",
          "system": "http://loinc.org",
          "display": "Discharge summary"
        } ]
      }
    }, {
      "id": "Composition.subject",
      "min": 1,
      "path": "Composition.subject",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-patient" ]
      } ],
      "mustSupport": true
    }, {
      "id": "Composition.encounter",
      "min": 1,
      "path": "Composition.encounter",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-encounter" ]
      } ],
      "short": "The hospital encounter being discharged from",
      "mustSupport": true
    }, {
      "id": "Composition.date",
      "path": "Composition.date",
      "mustSupport": true
    }, {
      "id": "Composition.author",
      "path": "Composition.author",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "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", "https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-organization" ]
      } ],
      "mustSupport": true
    }, {
      "id": "Composition.title",
      "path": "Composition.title",
      "short": "Hospital Discharge Report",
      "mustSupport": true
    }, {
      "id": "Composition.custodian",
      "path": "Composition.custodian",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-organization" ]
      } ],
      "mustSupport": true
    }, {
      "id": "Composition.section",
      "min": 2,
      "path": "Composition.section",
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "code",
          "type": "pattern"
        } ]
      }
    }, {
      "id": "Composition.section:encounterInformation",
      "max": "1",
      "min": 1,
      "path": "Composition.section",
      "short": "Encounter information — admission and discharge dates, reason for admission (mandatory)",
      "sliceName": "encounterInformation",
      "definition": "Mandatory section covering the hospital encounter: dates, reason for admission, and type. Corresponds to EHDSDischargeReport.body.encounterInformation in Xt-EHR v1.0.0.",
      "mustSupport": true
    }, {
      "id": "Composition.section:encounterInformation.code",
      "min": 1,
      "path": "Composition.section.code",
      "patternCodeableConcept": {
        "coding": [ {
          "code": "46241-6",
          "system": "http://loinc.org",
          "display": "Hospital admission diagnosis Narrative - Reported"
        } ]
      }
    }, {
      "id": "Composition.section:encounterInformation.text",
      "path": "Composition.section.text",
      "mustSupport": true
    }, {
      "id": "Composition.section:encounterInformation.entry",
      "path": "Composition.section.entry",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-encounter" ]
      } ],
      "mustSupport": true
    }, {
      "id": "Composition.section:courseOfEncounter",
      "max": "1",
      "min": 1,
      "path": "Composition.section",
      "short": "Course of encounter — diagnoses, procedures, medications, and key results (mandatory)",
      "sliceName": "courseOfEncounter",
      "definition": "Problems treated during the encounter, significant procedures, pharmacotherapy, and key test results. Corresponds to EHDSDischargeReport.body.courseOfEncounter in Xt-EHR v1.0.0.",
      "mustSupport": true
    }, {
      "id": "Composition.section:courseOfEncounter.code",
      "min": 1,
      "path": "Composition.section.code",
      "patternCodeableConcept": {
        "coding": [ {
          "code": "8648-8",
          "system": "http://loinc.org",
          "display": "Hospital course note"
        } ]
      }
    }, {
      "id": "Composition.section:courseOfEncounter.text",
      "path": "Composition.section.text",
      "mustSupport": true
    }, {
      "id": "Composition.section:courseOfEncounter.entry",
      "path": "Composition.section.entry",
      "mustSupport": true
    }, {
      "id": "Composition.section:courseOfEncounter.section",
      "path": "Composition.section.section",
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "code",
          "type": "pattern"
        } ]
      }
    }, {
      "id": "Composition.section:courseOfEncounter.section:diagnoses",
      "max": "1",
      "min": 0,
      "path": "Composition.section.section",
      "type": [ {
        "code": "BackboneElement"
      } ],
      "short": "Discharge diagnoses (EHDSCondition)",
      "sliceName": "diagnoses",
      "mustSupport": true
    }, {
      "id": "Composition.section:courseOfEncounter.section:diagnoses.code",
      "min": 1,
      "path": "Composition.section.section.code",
      "patternCodeableConcept": {
        "coding": [ {
          "code": "11535-2",
          "system": "http://loinc.org",
          "display": "Hospital discharge diagnosis note"
        } ]
      }
    }, {
      "id": "Composition.section:courseOfEncounter.section:diagnoses.entry",
      "path": "Composition.section.section.entry",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-condition-encounter-diagnosis" ]
      } ],
      "mustSupport": true
    }, {
      "id": "Composition.section:courseOfEncounter.section:procedures",
      "max": "1",
      "min": 0,
      "path": "Composition.section.section",
      "type": [ {
        "code": "BackboneElement"
      } ],
      "short": "Procedures performed during encounter",
      "sliceName": "procedures",
      "mustSupport": true
    }, {
      "id": "Composition.section:courseOfEncounter.section:procedures.code",
      "min": 1,
      "path": "Composition.section.section.code",
      "patternCodeableConcept": {
        "coding": [ {
          "code": "47519-4",
          "system": "http://loinc.org",
          "display": "History of Procedures Document"
        } ]
      }
    }, {
      "id": "Composition.section:courseOfEncounter.section:procedures.entry",
      "path": "Composition.section.section.entry",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-procedure" ]
      } ],
      "mustSupport": true
    }, {
      "id": "Composition.section:courseOfEncounter.section:pharmacotherapy",
      "max": "1",
      "min": 0,
      "path": "Composition.section.section",
      "type": [ {
        "code": "BackboneElement"
      } ],
      "short": "Significant pharmacotherapy during encounter (EHDSMedicationUse)",
      "sliceName": "pharmacotherapy",
      "mustSupport": true
    }, {
      "id": "Composition.section:courseOfEncounter.section:pharmacotherapy.code",
      "min": 1,
      "path": "Composition.section.section.code",
      "patternCodeableConcept": {
        "coding": [ {
          "code": "10160-0",
          "system": "http://loinc.org",
          "display": "History of Medication use Narrative"
        } ]
      }
    }, {
      "id": "Composition.section:courseOfEncounter.section:pharmacotherapy.entry",
      "path": "Composition.section.section.entry",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-medicationstatement", "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-medicationrequest" ]
      } ],
      "mustSupport": true
    }, {
      "id": "Composition.section:courseOfEncounter.section:testResults",
      "max": "1",
      "min": 0,
      "path": "Composition.section.section",
      "type": [ {
        "code": "BackboneElement"
      } ],
      "short": "Significant test results during encounter",
      "sliceName": "testResults",
      "mustSupport": true
    }, {
      "id": "Composition.section:courseOfEncounter.section:testResults.code",
      "min": 1,
      "path": "Composition.section.section.code",
      "patternCodeableConcept": {
        "coding": [ {
          "code": "30954-2",
          "system": "http://loinc.org",
          "display": "Relevant diagnostic tests/laboratory data note"
        } ]
      }
    }, {
      "id": "Composition.section:courseOfEncounter.section:testResults.entry",
      "path": "Composition.section.section.entry",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "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", "https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-diagnosticreport-lab" ]
      } ],
      "mustSupport": true
    }, {
      "id": "Composition.section:admissionEvaluation",
      "max": "1",
      "min": 0,
      "path": "Composition.section",
      "short": "Admission evaluation — objective findings and functional status at admission",
      "sliceName": "admissionEvaluation",
      "definition": "Objective findings (vital signs, physical examination) and functional status assessed at admission. Corresponds to EHDSDischargeReport.body.admissionEvaluation in Xt-EHR v1.0.0.",
      "mustSupport": true
    }, {
      "id": "Composition.section:admissionEvaluation.code",
      "min": 1,
      "path": "Composition.section.code",
      "patternCodeableConcept": {
        "coding": [ {
          "code": "57852-6",
          "system": "http://loinc.org",
          "display": "Problem list Narrative - Reported"
        } ]
      }
    }, {
      "id": "Composition.section:admissionEvaluation.text",
      "path": "Composition.section.text",
      "mustSupport": true
    }, {
      "id": "Composition.section:admissionEvaluation.entry",
      "path": "Composition.section.entry",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "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", "https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-condition-problems-health-concerns" ]
      } ],
      "mustSupport": true
    }, {
      "id": "Composition.section:patientHistory",
      "max": "1",
      "min": 0,
      "path": "Composition.section",
      "short": "Patient health history (anamnesis) relevant to this episode of care",
      "sliceName": "patientHistory",
      "definition": "Past problems, relevant prior procedures, and devices/implants from the patient's history that are important for continuity of care. Corresponds to EHDSDischargeReport.body.patientHistory in Xt-EHR v1.0.0.",
      "mustSupport": true
    }, {
      "id": "Composition.section:patientHistory.code",
      "min": 1,
      "path": "Composition.section.code",
      "patternCodeableConcept": {
        "coding": [ {
          "code": "11329-0",
          "system": "http://loinc.org",
          "display": "History general Narrative - Reported"
        } ]
      }
    }, {
      "id": "Composition.section:patientHistory.text",
      "path": "Composition.section.text",
      "mustSupport": true
    }, {
      "id": "Composition.section:patientHistory.entry",
      "path": "Composition.section.entry",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "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-condition-encounter-diagnosis", "https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-procedure", "https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-implantable-device" ]
      } ],
      "mustSupport": true
    }, {
      "id": "Composition.section:dischargeDetails",
      "max": "1",
      "min": 0,
      "path": "Composition.section",
      "short": "Discharge details — objective findings and functional status at discharge",
      "sliceName": "dischargeDetails",
      "definition": "Objective findings and functional status at the time of discharge. Corresponds to EHDSDischargeReport.body.dischargeDetails in Xt-EHR v1.0.0.",
      "mustSupport": true
    }, {
      "id": "Composition.section:dischargeDetails.code",
      "min": 1,
      "path": "Composition.section.code",
      "patternCodeableConcept": {
        "coding": [ {
          "code": "8650-4",
          "system": "http://loinc.org",
          "display": "Hospital discharge disposition note"
        } ]
      }
    }, {
      "id": "Composition.section:dischargeDetails.text",
      "path": "Composition.section.text",
      "mustSupport": true
    }, {
      "id": "Composition.section:dischargeDetails.entry",
      "path": "Composition.section.entry",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "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" ]
      } ],
      "mustSupport": true
    }, {
      "id": "Composition.section:alerts",
      "max": "1",
      "min": 0,
      "path": "Composition.section",
      "short": "Alerts — substantial medical alerts or warnings (EHDSAlert)",
      "sliceName": "alerts",
      "definition": "Substantial alerts or warnings that health professionals should be aware of, including allergies. Added in Xt-EHR EHDSDischargeReport v1.0.0.",
      "mustSupport": true
    }, {
      "id": "Composition.section:alerts.code",
      "min": 1,
      "path": "Composition.section.code",
      "patternCodeableConcept": {
        "coding": [ {
          "code": "104605-1",
          "system": "http://loinc.org",
          "display": "Alert"
        } ]
      }
    }, {
      "id": "Composition.section:alerts.text",
      "path": "Composition.section.text",
      "mustSupport": true
    }, {
      "id": "Composition.section:alerts.entry",
      "path": "Composition.section.entry",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-flag", "https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-allergyintolerance" ]
      } ],
      "mustSupport": true
    }, {
      "id": "Composition.section:medicationSummary",
      "max": "1",
      "min": 0,
      "path": "Composition.section",
      "short": "Discharge medications (EHDSMedicationUse)",
      "sliceName": "medicationSummary",
      "definition": "Medications recommended for the post-discharge period, including newly started, changed, and discontinued medications.",
      "mustSupport": true
    }, {
      "id": "Composition.section:medicationSummary.code",
      "min": 1,
      "path": "Composition.section.code",
      "patternCodeableConcept": {
        "coding": [ {
          "code": "75311-1",
          "system": "http://loinc.org",
          "display": "Discharge medications note"
        } ]
      }
    }, {
      "id": "Composition.section:medicationSummary.text",
      "path": "Composition.section.text",
      "mustSupport": true
    }, {
      "id": "Composition.section:medicationSummary.entry",
      "path": "Composition.section.entry",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "https://hl7-ie.github.io/ie-core/fhir/ie/core/StructureDefinition/ie-core-medicationstatement", "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-medicationrequest" ]
      } ],
      "mustSupport": true
    }, {
      "id": "Composition.section:carePlan",
      "max": "1",
      "min": 0,
      "path": "Composition.section",
      "short": "Post-discharge care plan and follow-up recommendations",
      "sliceName": "carePlan",
      "mustSupport": true
    }, {
      "id": "Composition.section:carePlan.code",
      "min": 1,
      "path": "Composition.section.code",
      "patternCodeableConcept": {
        "coding": [ {
          "code": "18776-5",
          "system": "http://loinc.org",
          "display": "Plan of care note"
        } ]
      }
    }, {
      "id": "Composition.section:carePlan.text",
      "path": "Composition.section.text",
      "mustSupport": true
    }, {
      "id": "Composition.section:carePlan.entry",
      "path": "Composition.section.entry",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "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" ]
      } ],
      "mustSupport": true
    } ]
  },
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Composition"
}