Consolidated CDA
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This page is part of the CCDA: Consolidated CDA Release (v3.0.0-ballot: CCDA 3.0 Ballot 1) based on FHIR (HL7® FHIR® Standard) v5.0.0. . For a full list of available versions, see the Directory of published versions

Logical Model: Instruction - XML Profile

Draft as of 2023-12-21

XML representation of the Instruction logical model.

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<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="Instruction"/>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="The logical name of the element">Name</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Information about the use of the element">Flags</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Minimum and Maximum # of times the the element can appear in the instance">Card.</a></th><th style="width: 100px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Reference to the type of the element">Type</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Additional information about the element">Description &amp; Constraints</a><span style="float: right"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-Instruction-definitions.html#Act">Act</a><a name="Act"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="padding-left: 3px; padding-right: 3px; border: 1px maroon solid; font-weight: bold; color: #301212; background-color: #fdf4f4;" href="http://hl7.org/fhir/R5/conformance-rules.html#constraints" title="This element has or is affected by constraints (should-text-ref-value)">C</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-Act.html">Act</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="font-weight:bold">XML Namespace: </span>urn:hl7-org:v3<br/>Elements defined in Ancestors: <a href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-ANY.html" title="If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.">@nullFlavor</a>, <a href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-InfrastructureRoot.html" title="When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question">realmCode</a>, <a href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-InfrastructureRoot.html" title="When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.">typeId</a>, <a href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-InfrastructureRoot.html" title="When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question">templateId</a>, <a href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-Act.html">@classCode</a>, <a href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-Act.html">@moodCode</a>, <a href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-Act.html">@negationInd</a>, <a href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-Act.html">id</a>, <a href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-Act.html">code</a>, <a href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-Act.html">text</a>, <a href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-Act.html">statusCode</a>, <a href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-Act.html">effectiveTime</a>, <a href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-Act.html">priorityCode</a>, <a href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-Act.html">languageCode</a>, <a href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-Act.html">subject</a>, <a href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-Act.html">specimen</a>, <a href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-Act.html">performer</a>, <a href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-Act.html">author</a>, <a href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-Act.html">informant</a>, <a href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-Act.html">participant</a>, <a href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-Act.html">entryRelationship</a>, <a href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-Act.html">reference</a>, <a href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-Act.html">precondition</a>, <a href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-Act.html">sdtcPrecondition2</a>, <a href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-Act.html">sdtcInFulfillmentOf1</a><br/><span style="opacity: 0.5">Base for all types and resources</span><br/><span style="font-weight:bold">Instances of this type are validated by templateId</span><br/><span style="font-weight:bold" title="The root class that contains instances of this class">Logical Container: </span><a href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-ClinicalDocument.html">ClinicalDocument (CDA Class)</a><br/><span style="font-weight:bold">should-text-ref-value: </span>SHOULD contain text/reference/@value</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck13.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Slice Definition" class="hierarchy"/> <a style="font-style: italic" href="StructureDefinition-Instruction-definitions.html#Act.templateId">Slices for templateId</a><a name="Act.templateId"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="font-style: italic"/><span style="font-style: italic">1</span><span style="font-style: italic">..</span><span style="opacity: 0.5; font-style: italic">*</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5; font-style: italic" href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-II.html">II</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="font-weight:bold; font-style: italic">Slice: </span><span style="font-style: italic">Unordered, Open by value:root, value:extension</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck125.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slicer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_slice_item.png" alt="." style="background-color: white; background-color: inherit" title="Slice Item" class="hierarchy"/> <a href="StructureDefinition-Instruction-definitions.html#Act.templateId:instruction" title="Slice instruction">templateId:instruction</a><a name="Act.templateId"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-II.html">II</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1250.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_slice.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-Instruction-definitions.html#Act.templateId:instruction.root">@root</a><a name="Act.templateId.root"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-oid.html" title="string">oid</a><span style="opacity: 0.5">, </span><a style="opacity: 0.5" href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-uuid.html" title="string">uuid</a><span style="opacity: 0.5">, </span><a style="opacity: 0.5" href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-ruid.html" title="string">ruid</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="font-weight:bold">Required Pattern: </span><span style="color: darkgreen">2.16.840.1.113883.10.20.22.4.20</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1240.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end_slice.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_extension_simple.png" alt="." style="background-color: white; background-color: inherit" title="Simple Extension" class="hierarchy"/> <a href="StructureDefinition-Instruction-definitions.html#Act.templateId:instruction.extension">@extension</a><a name="Act.templateId.extension"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-st-simple.html" title="string">st</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="font-weight:bold">Required Pattern: </span><span style="color: darkgreen">2014-06-09</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-Instruction-definitions.html#Act.classCode">@classCode</a><a name="Act.classCode"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-cs-simple.html" title="code">cs</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="font-weight:bold">Fixed Value: </span><span style="color: darkgreen">ACT</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-Instruction-definitions.html#Act.moodCode">@moodCode</a><a name="Act.moodCode"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-cs-simple.html" title="code">cs</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="font-weight:bold">Fixed Value: </span><span style="color: darkgreen">INT</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-Instruction-definitions.html#Act.code">code</a><a name="Act.code"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">1</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-CD.html">CD</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="font-weight:bold">Binding: </span><a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.11.20.9.34/expansion">Patient Education</a> (<a href="http://hl7.org/fhir/R5/terminologies.html#preferred" title="Instances are encouraged to draw from the specified codes for interoperability purposes but are not required to do so to be considered conformant.">preferred</a>)</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-Instruction-definitions.html#Act.text">text</a><a name="Act.text"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-ED.html">ED</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">SHOULD reference the portion of section narrative text corresponding to this entry</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-Instruction-definitions.html#Act.text.reference">reference</a><a name="Act.text.reference"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="padding-left: 3px; padding-right: 3px; border: 1px maroon solid; font-weight: bold; color: #301212; background-color: #fdf4f4;" href="http://hl7.org/fhir/R5/conformance-rules.html#constraints" title="This element has or is affected by constraints (value-starts-octothorpe)">C</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-TEL.html">TEL</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="font-weight:bold">value-starts-octothorpe: </span>If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-Instruction-definitions.html#Act.statusCode">statusCode</a><a name="Act.statusCode"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-CS.html">CS</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck000.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-Instruction-definitions.html#Act.statusCode.code">@code</a><a name="Act.statusCode.code"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..<span style="opacity: 0.5">1</span></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a style="opacity: 0.5" href="http://hl7.org/cda/stds/core/2.0.0-sd-snapshot1/StructureDefinition-cs-simple.html" title="code">cs</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="font-weight:bold">Fixed Value: </span><span style="color: darkgreen">completed</span></td></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
  </text>
  <extension
             url="http://hl7.org/fhir/tools/StructureDefinition/logical-target">
    <valueBoolean>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/data-absent-reason">
        <valueCode value="not-applicable"/>
      </extension>
    </valueBoolean>
  </extension>
  <extension
             url="http://hl7.org/fhir/tools/StructureDefinition/logical-container">
    <valueUri
              value="http://hl7.org/cda/stds/core/StructureDefinition/ClinicalDocument"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/tools/StructureDefinition/xml-namespace">
    <valueUri value="urn:hl7-org:v3"/>
  </extension>
  <extension url="http://hl7.org/fhir/tools/StructureDefinition/xml-name">
    <valueString value="act"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/tools/StructureDefinition/type-profile-style">
    <valueUri value="cda"/>
  </extension>
  <url value="http://hl7.org/cda/us/ccda/StructureDefinition/Instruction"/>
  <identifier>
    <value value="urn:hl7ii:2.16.840.1.113883.10.20.22.4.20:2014-06-09"/>
  </identifier>
  <version value="3.0.0-ballot"/>
  <name value="Instruction"/>
  <title value="Instruction"/>
  <status value="draft"/>
  <date value="2023-12-21T01:13:10+10:00"/>
  <publisher value="Health Level Seven"/>
  <contact>
    <name value="HL7 International - Structured Documents"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/structure"/>
    </telecom>
  </contact>
  <description
               value="The Instruction template can be used in several ways, such as to record patient instructions within a Medication Activity or to record fill instructions within a supply order. The template's moodCode can only be INT. If an instruction was already given, the Procedure Activity Procedure template (instead of this template) should be used to represent the already occurred instruction. The act/code defines the type of instruction. Though not defined in this template, a Vaccine Information Statement (VIS) document could be referenced through act/reference/externalDocument, and patient awareness of the instructions can be represented with the generic participant and the participant/awarenessCode."/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
    </coding>
  </jurisdiction>
  <fhirVersion value="5.0.0"/>
  <mapping>
    <identity value="rim"/>
    <uri value="http://hl7.org/v3"/>
    <name value="RIM Mapping"/>
  </mapping>
  <kind value="logical"/>
  <abstract value="false"/>
  <type value="http://hl7.org/cda/stds/core/StructureDefinition/Act"/>
  <baseDefinition
                  value="http://hl7.org/cda/stds/core/StructureDefinition/Act"/>
  <derivation value="constraint"/>
  <snapshot>
    <element id="Act">
      <path value="Act"/>
      <short value="Base for all types and resources"/>
      <definition
                  value="Defines the basic properties of every data value. This is an abstract type, meaning that no value can be just a data value without belonging to any concrete type. Every concrete type is a specialization of this general abstract DataValue type."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Base"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <constraint>
        <key value="should-text-ref-value"/>
        <severity value="warning"/>
        <human value="SHOULD contain text/reference/@value"/>
        <expression value="text.reference.value.exists()"/>
        <source
                value="http://hl7.org/cda/us/ccda/StructureDefinition/Instruction"/>
      </constraint>
      <isModifier value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Act.nullFlavor">
      <path value="Act.nullFlavor"/>
      <representation value="xmlAttr"/>
      <label value="Exceptional Value Detail"/>
      <definition
                  value="If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ANY.nullFlavor"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/cs-simple"/>
      </type>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor"/>
      </binding>
    </element>
    <element id="Act.realmCode">
      <path value="Act.realmCode"/>
      <definition
                  value="When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="InfrastructureRoot.realmCode"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="http://hl7.org/cda/stds/core/StructureDefinition/CS"/>
      </type>
    </element>
    <element id="Act.typeId">
      <path value="Act.typeId"/>
      <definition
                  value="When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="InfrastructureRoot.typeId"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="http://hl7.org/cda/stds/core/StructureDefinition/II"/>
      </type>
    </element>
    <element id="Act.typeId.nullFlavor">
      <path value="Act.typeId.nullFlavor"/>
      <representation value="xmlAttr"/>
      <label value="Exceptional Value Detail"/>
      <definition
                  value="If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ANY.nullFlavor"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/cs-simple"/>
      </type>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor"/>
      </binding>
    </element>
    <element id="Act.typeId.assigningAuthorityName">
      <path value="Act.typeId.assigningAuthorityName"/>
      <representation value="xmlAttr"/>
      <label value="Assigning Authority Name"/>
      <definition
                  value="A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="II.assigningAuthorityName"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/st-simple"/>
      </type>
    </element>
    <element id="Act.typeId.displayable">
      <path value="Act.typeId.displayable"/>
      <representation value="xmlAttr"/>
      <label value="Displayable"/>
      <definition
                  value="Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="II.displayable"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/bl-simple"/>
      </type>
    </element>
    <element id="Act.typeId.root">
      <path value="Act.typeId.root"/>
      <representation value="xmlAttr"/>
      <label value="Root"/>
      <definition value="Identifies the type as an HL7 Registered model"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="II.root"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/oid"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/uuid"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/ruid"/>
      </type>
      <fixedString value="2.16.840.1.113883.1.3"/>
    </element>
    <element id="Act.typeId.extension">
      <path value="Act.typeId.extension"/>
      <representation value="xmlAttr"/>
      <label value="Extension"/>
      <definition
                  value="A character string as a unique identifier within the scope of the identifier root."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="II.extension"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/st-simple"/>
      </type>
    </element>
    <element id="Act.templateId">
      <path value="Act.templateId"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="root"/>
        </discriminator>
        <discriminator>
          <type value="value"/>
          <path value="extension"/>
        </discriminator>
        <rules value="open"/>
      </slicing>
      <definition
                  value="When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question"/>
      <min value="1"/>
      <max value="*"/>
      <base>
        <path value="InfrastructureRoot.templateId"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="http://hl7.org/cda/stds/core/StructureDefinition/II"/>
      </type>
    </element>
    <element id="Act.templateId:instruction">
      <path value="Act.templateId"/>
      <sliceName value="instruction"/>
      <definition
                  value="When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="InfrastructureRoot.templateId"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="http://hl7.org/cda/stds/core/StructureDefinition/II"/>
      </type>
    </element>
    <element id="Act.templateId:instruction.nullFlavor">
      <path value="Act.templateId.nullFlavor"/>
      <representation value="xmlAttr"/>
      <label value="Exceptional Value Detail"/>
      <definition
                  value="If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ANY.nullFlavor"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/cs-simple"/>
      </type>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor"/>
      </binding>
    </element>
    <element id="Act.templateId:instruction.assigningAuthorityName">
      <path value="Act.templateId.assigningAuthorityName"/>
      <representation value="xmlAttr"/>
      <label value="Assigning Authority Name"/>
      <definition
                  value="A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="II.assigningAuthorityName"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/st-simple"/>
      </type>
    </element>
    <element id="Act.templateId:instruction.displayable">
      <path value="Act.templateId.displayable"/>
      <representation value="xmlAttr"/>
      <label value="Displayable"/>
      <definition
                  value="Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="II.displayable"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/bl-simple"/>
      </type>
    </element>
    <element id="Act.templateId:instruction.root">
      <path value="Act.templateId.root"/>
      <representation value="xmlAttr"/>
      <label value="Root"/>
      <definition
                  value="A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="II.root"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/oid"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/uuid"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/ruid"/>
      </type>
      <patternString value="2.16.840.1.113883.10.20.22.4.20"/>
    </element>
    <element id="Act.templateId:instruction.extension">
      <path value="Act.templateId.extension"/>
      <representation value="xmlAttr"/>
      <label value="Extension"/>
      <definition
                  value="A character string as a unique identifier within the scope of the identifier root."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="II.extension"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/st-simple"/>
      </type>
      <patternString value="2014-06-09"/>
    </element>
    <element id="Act.classCode">
      <path value="Act.classCode"/>
      <representation value="xmlAttr"/>
      <comment
               value="SHALL contain exactly one [1..1] @classCode=&quot;ACT&quot; (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC) (CONF:1098-7391)."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Act.classCode"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/cs-simple"/>
      </type>
      <fixedCode value="ACT"/>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="http://terminology.hl7.org/ValueSet/v3-xActClassDocumentEntryAct|2.0.0"/>
      </binding>
    </element>
    <element id="Act.moodCode">
      <path value="Act.moodCode"/>
      <representation value="xmlAttr"/>
      <comment
               value="SHALL contain exactly one [1..1] @moodCode=&quot;INT&quot; (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001 STATIC) (CONF:1098-7392)."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Act.moodCode"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/cs-simple"/>
      </type>
      <fixedCode value="INT"/>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="http://terminology.hl7.org/ValueSet/v3-xDocumentActMood|2.0.0"/>
      </binding>
    </element>
    <element id="Act.negationInd">
      <path value="Act.negationInd"/>
      <representation value="xmlAttr"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Act.negationInd"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/bl-simple"/>
      </type>
    </element>
    <element id="Act.id">
      <path value="Act.id"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Act.id"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="http://hl7.org/cda/stds/core/StructureDefinition/II"/>
      </type>
    </element>
    <element id="Act.code">
      <path value="Act.code"/>
      <comment
               value="SHALL contain exactly one [1..1] code, which SHOULD be selected from ValueSet Patient Education urn:oid:2.16.840.1.113883.11.20.9.34 DYNAMIC (CONF:1098-16884)."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Act.code"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="http://hl7.org/cda/stds/core/StructureDefinition/CD"/>
      </type>
      <binding>
        <strength value="preferred"/>
        <valueSet
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.34"/>
      </binding>
    </element>
    <element id="Act.text">
      <path value="Act.text"/>
      <short
             value="SHOULD reference the portion of section narrative text corresponding to this entry"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Act.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="http://hl7.org/cda/stds/core/StructureDefinition/ED"/>
      </type>
    </element>
    <element id="Act.text.nullFlavor">
      <path value="Act.text.nullFlavor"/>
      <representation value="xmlAttr"/>
      <label value="Exceptional Value Detail"/>
      <definition
                  value="If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ANY.nullFlavor"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/cs-simple"/>
      </type>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor"/>
      </binding>
    </element>
    <element id="Act.text.compression">
      <path value="Act.text.compression"/>
      <representation value="xmlAttr"/>
      <label value="Compression"/>
      <definition
                  value="Indicates whether the raw byte data is compressed, and what compression algorithm was used."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ED.compression"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/cs-simple"/>
      </type>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm"/>
      </binding>
    </element>
    <element id="Act.text.integrityCheck">
      <path value="Act.text.integrityCheck"/>
      <representation value="xmlAttr"/>
      <label value="Integrity Check"/>
      <definition
                  value="The integrity check is a short binary value representing a cryptographically strong checksum that is calculated over the binary data. The purpose of this property, when communicated with a reference is for anyone to validate later whether the reference still resolved to the same data that the reference resolved to when the encapsulated data value with reference was created."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ED.integrityCheck"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="base64Binary"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/bin"/>
      </type>
    </element>
    <element id="Act.text.integrityCheckAlgorithm">
      <path value="Act.text.integrityCheckAlgorithm"/>
      <representation value="xmlAttr"/>
      <label value="Integrity Check Algorithm"/>
      <definition
                  value="Specifies the algorithm used to compute the integrityCheck value. The cryptographically strong checksum algorithm Secure Hash Algorithm-1 (SHA-1) is currently the industry standard. It has superseded the MD5 algorithm only a couple of years ago, when certain flaws in the security of MD5 were discovered. Currently the SHA-1 hash algorithm is the default choice for the integrity check algorithm. Note that SHA-256 is also entering widespread usage."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ED.integrityCheckAlgorithm"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/cs-simple"/>
      </type>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0"/>
      </binding>
    </element>
    <element id="Act.text.language">
      <path value="Act.text.language"/>
      <representation value="xmlAttr"/>
      <label value="Language"/>
      <definition
                  value="For character based information the language property specifies the human language of the text."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ED.language"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/cs-simple"/>
      </type>
    </element>
    <element id="Act.text.mediaType">
      <path value="Act.text.mediaType"/>
      <representation value="xmlAttr"/>
      <label value="Media Type"/>
      <definition
                  value="Identifies the type of the encapsulated data and identifies a method to interpret or render the data."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ED.mediaType"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/cs-simple"/>
      </type>
      <binding>
        <strength value="example"/>
        <valueSet value="http://terminology.hl7.org/ValueSet/v3-MediaType"/>
      </binding>
    </element>
    <element id="Act.text.representation">
      <path value="Act.text.representation"/>
      <representation value="xmlAttr"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ED.representation"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/cs-simple"/>
      </type>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding"/>
      </binding>
    </element>
    <element id="Act.text.xmlText">
      <path value="Act.text.xmlText"/>
      <representation value="xmlText"/>
      <short
             value="Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string."/>
      <definition
                  value="Data that is primarily intended for human interpretation or for further machine processing is outside the scope of HL7. This includes unformatted or formatted written language, multimedia data, or structured information as defined by a different standard (e.g., XML-signatures.)"/>
      <comment
               value="This element is represented in XML as textual content. The actual name &quot;xmlText&quot; will not appear in a CDA instance."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ED.xmlText"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/st-simple"/>
      </type>
    </element>
    <element id="Act.text.reference">
      <path value="Act.text.reference"/>
      <label value="Reference"/>
      <definition
                  value="A telecommunication address (TEL), such as a URL for HTTP or FTP, which will resolve to precisely the same binary data that could as well have been provided as inline data."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ED.reference"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="http://hl7.org/cda/stds/core/StructureDefinition/TEL"/>
      </type>
      <constraint>
        <key value="value-starts-octothorpe"/>
        <severity value="error"/>
        <human
               value="If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative"/>
        <expression value="value.exists() implies value.startsWith('#')"/>
        <source
                value="http://hl7.org/cda/us/ccda/StructureDefinition/Instruction"/>
      </constraint>
    </element>
    <element id="Act.text.thumbnail">
      <path value="Act.text.thumbnail"/>
      <label value="Thumbnail"/>
      <definition
                  value="An abbreviated rendition of the full data. A thumbnail requires significantly fewer resources than the full data, while still maintaining some distinctive similarity with the full data. A thumbnail is typically used with by-reference encapsulated data. It allows a user to select data more efficiently before actually downloading through the reference."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ED.thumbnail"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="http://hl7.org/cda/stds/core/StructureDefinition/ED"/>
      </type>
    </element>
    <element id="Act.statusCode">
      <path value="Act.statusCode"/>
      <comment
               value="SHALL contain exactly one [1..1] statusCode (CONF:1098-7396)."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Act.statusCode"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="http://hl7.org/cda/stds/core/StructureDefinition/CS"/>
      </type>
      <binding>
        <strength value="required"/>
        <valueSet value="http://terminology.hl7.org/ValueSet/v3-ActStatus"/>
      </binding>
    </element>
    <element id="Act.statusCode.nullFlavor">
      <path value="Act.statusCode.nullFlavor"/>
      <representation value="xmlAttr"/>
      <label value="Exceptional Value Detail"/>
      <definition
                  value="If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ANY.nullFlavor"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/cs-simple"/>
      </type>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor"/>
      </binding>
    </element>
    <element id="Act.statusCode.code">
      <path value="Act.statusCode.code"/>
      <representation value="xmlAttr"/>
      <label value="Code"/>
      <definition
                  value="The plain code symbol defined by the code system. For example, &quot;784.0&quot; is the code symbol of the ICD-9 code &quot;784.0&quot; for headache."/>
      <comment
               value="This statusCode SHALL contain exactly one [1..1] @code=&quot;completed&quot; Completed (CodeSystem: HL7ActStatus urn:oid:2.16.840.1.113883.5.14 STATIC) (CONF:1098-19106)."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="CD.code"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/cs-simple"/>
      </type>
      <fixedCode value="completed"/>
    </element>
    <element id="Act.statusCode.codeSystem">
      <path value="Act.statusCode.codeSystem"/>
      <representation value="xmlAttr"/>
      <label value="Code System"/>
      <definition value="Specifies the code system that defines the code."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="CD.codeSystem"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/oid"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/uuid"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/ruid"/>
      </type>
    </element>
    <element id="Act.statusCode.codeSystemName">
      <path value="Act.statusCode.codeSystemName"/>
      <representation value="xmlAttr"/>
      <label value="Code System Name"/>
      <definition value="The common name of the coding system."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="CD.codeSystemName"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/st-simple"/>
      </type>
    </element>
    <element id="Act.statusCode.codeSystemVersion">
      <path value="Act.statusCode.codeSystemVersion"/>
      <representation value="xmlAttr"/>
      <label value="Code System Version"/>
      <definition
                  value="If applicable, a version descriptor defined specifically for the given code system."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="CD.codeSystemVersion"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/st-simple"/>
      </type>
    </element>
    <element id="Act.statusCode.displayName">
      <path value="Act.statusCode.displayName"/>
      <representation value="xmlAttr"/>
      <label value="Display Name"/>
      <definition
                  value="A name or title for the code, under which the sending system shows the code value to its users."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="CD.displayName"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/st-simple"/>
      </type>
    </element>
    <element id="Act.statusCode.sdtcValueSet">
      <extension
                 url="http://hl7.org/fhir/tools/StructureDefinition/xml-namespace">
        <valueUri value="urn:hl7-org:sdtc"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/tools/StructureDefinition/xml-name">
        <valueString value="valueSet"/>
      </extension>
      <path value="Act.statusCode.sdtcValueSet"/>
      <representation value="xmlAttr"/>
      <definition
                  value="The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="CD.valueSet"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/oid"/>
      </type>
    </element>
    <element id="Act.statusCode.sdtcValueSetVersion">
      <extension
                 url="http://hl7.org/fhir/tools/StructureDefinition/xml-namespace">
        <valueUri value="urn:hl7-org:sdtc"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/tools/StructureDefinition/xml-name">
        <valueString value="valueSetVersion"/>
      </extension>
      <path value="Act.statusCode.sdtcValueSetVersion"/>
      <representation value="xmlAttr"/>
      <definition
                  value="The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="CD.sdtcValueSetVersion"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
        <profile
                 value="http://hl7.org/cda/stds/core/StructureDefinition/st-simple"/>
      </type>
    </element>
    <element id="Act.statusCode.originalText">
      <path value="Act.statusCode.originalText"/>
      <label value="Original Text"/>
      <definition
                  value="The text or phrase used as the basis for the coding."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="CD.originalText"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="http://hl7.org/cda/stds/core/StructureDefinition/ED"/>
      </type>
    </element>
    <element id="Act.statusCode.qualifier">
      <path value="Act.statusCode.qualifier"/>
      <label value="Qualifier"/>
      <definition
                  value="Specifies additional codes that increase the specificity of the the primary code."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="CD.qualifier"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="http://hl7.org/cda/stds/core/StructureDefinition/CR"/>
      </type>
    </element>
    <element id="Act.statusCode.translation">
      <path value="Act.statusCode.translation"/>
      <representation value="typeAttr"/>
      <label value="Translation"/>
      <definition
                  value="A set of other concept descriptors that translate this concept descriptor into other code systems."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="CD.translation"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="http://hl7.org/cda/stds/core/StructureDefinition/CD"/>
      </type>
    </element>
    <element id="Act.effectiveTime">
      <path value="Act.effectiveTime"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Act.effectiveTime"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code
              value="http://hl7.org/cda/stds/core/StructureDefinition/IVL-TS"/>
      </type>
    </element>
    <element id="Act.priorityCode">
      <path value="Act.priorityCode"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Act.priorityCode"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="http://hl7.org/cda/stds/core/StructureDefinition/CE"/>
      </type>
      <binding>
        <strength value="example"/>
        <valueSet value="http://terminology.hl7.org/ValueSet/v3-ActPriority"/>
      </binding>
    </element>
    <element id="Act.languageCode">
      <path value="Act.languageCode"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Act.languageCode"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="http://hl7.org/cda/stds/core/StructureDefinition/CS"/>
      </type>
      <binding>
        <strength value="required"/>
        <valueSet value="http://hl7.org/fhir/ValueSet/all-languages"/>
      </binding>
    </element>
    <element id="Act.subject">
      <path value="Act.subject"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Act.subject"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code
              value="http://hl7.org/cda/stds/core/StructureDefinition/Subject"/>
      </type>
    </element>
    <element id="Act.specimen">
      <path value="Act.specimen"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Act.specimen"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code
              value="http://hl7.org/cda/stds/core/StructureDefinition/Specimen"/>
      </type>
    </element>
    <element id="Act.performer">
      <path value="Act.performer"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Act.performer"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code
              value="http://hl7.org/cda/stds/core/StructureDefinition/Performer2"/>
      </type>
    </element>
    <element id="Act.author">
      <path value="Act.author"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Act.author"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code
              value="http://hl7.org/cda/stds/core/StructureDefinition/Author"/>
      </type>
    </element>
    <element id="Act.informant">
      <path value="Act.informant"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Act.informant"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code
              value="http://hl7.org/cda/stds/core/StructureDefinition/Informant"/>
      </type>
    </element>
    <element id="Act.participant">
      <path value="Act.participant"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Act.participant"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code
              value="http://hl7.org/cda/stds/core/StructureDefinition/Participant2"/>
      </type>
    </element>
    <element id="Act.entryRelationship">
      <path value="Act.entryRelationship"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Act.entryRelationship"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code
              value="http://hl7.org/cda/stds/core/StructureDefinition/EntryRelationship"/>
      </type>
    </element>
    <element id="Act.reference">
      <path value="Act.reference"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Act.reference"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code
              value="http://hl7.org/cda/stds/core/StructureDefinition/Reference"/>
      </type>
    </element>
    <element id="Act.precondition">
      <path value="Act.precondition"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Act.precondition"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code
              value="http://hl7.org/cda/stds/core/StructureDefinition/Precondition"/>
      </type>
    </element>
    <element id="Act.sdtcPrecondition2">
      <extension
                 url="http://hl7.org/fhir/tools/StructureDefinition/xml-namespace">
        <valueUri value="urn:hl7-org:sdtc"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/tools/StructureDefinition/xml-name">
        <valueString value="precondition2"/>
      </extension>
      <path value="Act.sdtcPrecondition2"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Act.sdtcPrecondition2"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code
              value="http://hl7.org/cda/stds/core/StructureDefinition/Precondition2"/>
      </type>
    </element>
    <element id="Act.sdtcInFulfillmentOf1">
      <extension
                 url="http://hl7.org/fhir/tools/StructureDefinition/xml-namespace">
        <valueUri value="urn:hl7-org:sdtc"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/tools/StructureDefinition/xml-name">
        <valueString value="inFulfillmentOf1"/>
      </extension>
      <path value="Act.sdtcInFulfillmentOf1"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Act.sdtcInFulfillmentOf1"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code
              value="http://hl7.org/cda/stds/core/StructureDefinition/InFulfillmentOf1"/>
      </type>
    </element>
  </snapshot>
  <differential>
    <element id="Act">
      <path value="Act"/>
      <constraint>
        <key value="should-text-ref-value"/>
        <severity value="warning"/>
        <human value="SHOULD contain text/reference/@value"/>
        <expression value="text.reference.value.exists()"/>
        <source
                value="http://hl7.org/cda/us/ccda/StructureDefinition/Instruction"/>
      </constraint>
    </element>
    <element id="Act.templateId">
      <path value="Act.templateId"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="root"/>
        </discriminator>
        <discriminator>
          <type value="value"/>
          <path value="extension"/>
        </discriminator>
        <rules value="open"/>
      </slicing>
      <min value="1"/>
    </element>
    <element id="Act.templateId:instruction">
      <path value="Act.templateId"/>
      <sliceName value="instruction"/>
      <min value="1"/>
      <max value="1"/>
    </element>
    <element id="Act.templateId:instruction.root">
      <path value="Act.templateId.root"/>
      <min value="1"/>
      <patternString value="2.16.840.1.113883.10.20.22.4.20"/>
    </element>
    <element id="Act.templateId:instruction.extension">
      <path value="Act.templateId.extension"/>
      <min value="1"/>
      <patternString value="2014-06-09"/>
    </element>
    <element id="Act.classCode">
      <path value="Act.classCode"/>
      <comment
               value="SHALL contain exactly one [1..1] @classCode=&quot;ACT&quot; (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC) (CONF:1098-7391)."/>
      <fixedCode value="ACT"/>
    </element>
    <element id="Act.moodCode">
      <path value="Act.moodCode"/>
      <comment
               value="SHALL contain exactly one [1..1] @moodCode=&quot;INT&quot; (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001 STATIC) (CONF:1098-7392)."/>
      <fixedCode value="INT"/>
    </element>
    <element id="Act.code">
      <path value="Act.code"/>
      <comment
               value="SHALL contain exactly one [1..1] code, which SHOULD be selected from ValueSet Patient Education urn:oid:2.16.840.1.113883.11.20.9.34 DYNAMIC (CONF:1098-16884)."/>
      <binding>
        <strength value="preferred"/>
        <valueSet
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.11.20.9.34"/>
      </binding>
    </element>
    <element id="Act.text">
      <path value="Act.text"/>
      <short
             value="SHOULD reference the portion of section narrative text corresponding to this entry"/>
    </element>
    <element id="Act.text.reference">
      <path value="Act.text.reference"/>
      <constraint>
        <key value="value-starts-octothorpe"/>
        <severity value="error"/>
        <human
               value="If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative"/>
        <expression value="value.exists() implies value.startsWith('#')"/>
        <source
                value="http://hl7.org/cda/us/ccda/StructureDefinition/Instruction"/>
      </constraint>
    </element>
    <element id="Act.statusCode">
      <path value="Act.statusCode"/>
      <comment
               value="SHALL contain exactly one [1..1] statusCode (CONF:1098-7396)."/>
      <min value="1"/>
    </element>
    <element id="Act.statusCode.code">
      <path value="Act.statusCode.code"/>
      <comment
               value="This statusCode SHALL contain exactly one [1..1] @code=&quot;completed&quot; Completed (CodeSystem: HL7ActStatus urn:oid:2.16.840.1.113883.5.14 STATIC) (CONF:1098-19106)."/>
      <min value="1"/>
      <fixedCode value="completed"/>
    </element>
  </differential>
</StructureDefinition>