2nd DSTU Draft For Comment

This page is part of the FHIR Specification (v0.4.0: DSTU 2 Draft). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions

Profile: StructuredDataCaptureValueSet

StructuredDataCaptureValueSet

Raw XML

<Profile xmlns="http://hl7.org/fhir">
  <id value="valueset-sdc-de-structureddatacapturevalueset"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><!-- Snipped for brevity --></div>
  </text>
  <url value="http://hl7.org/fhir/Profile/valueset-sdc-de-structureddatacapturevalueset"/>
  <name value="Structured Data Capture Data Element Exchange Value Set"/>
  <publisher value="U.S. Office of the National Coordinator (ONC)'s Standards and Infrastructure (S&amp;I)
   Structured Data Capture project"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://wiki.siframework.org/Structured+Data+Capture+Initiative"/>
    </telecom>
  </contact>
  <description value="Defines how ValueSet is used to reflect code lists found in data element defintions for
   exchange and maintenance between data element registries according to requirements established
   by the ONC's Structured Data Capture standard. : Structured Data Capture Data Element
   Exchange Value Set"/>
  <status value="draft"/>
  <date value="2014-07-06"/>
  <mapping>
    <identity value="ihesdc"/>
    <uri value="http://wiki.siframework.org/IHE+SDC+Profile"/>
    <name value="IHE Structured Data Capture"/>
  </mapping>
  <type value="ValueSet"/>
  <base value="http://hl7.org/fhir/Profile/ValueSet"/>
  <snapshot>
    <element>
      <path value="ValueSet"/>
      <name value="StructuredDataCaptureValueSet"/>
      <short value="A set of codes drawn from one or more code systems"/>
      <definition value="A value set specifies a set of codes drawn from one or more code systems."/>
      <min value="1"/>
      <max value="1"/>
      <constraint>
        <key value="vsd-7"/>
        <severity value="error"/>
        <human value="A defined code system (if present) SHALL have a different identifier to the value set
         itself"/>
        <xpath value="not(f:define/f:system/@value = f:identifier/@value)"/>
      </constraint>
      <constraint>
        <key value="vsd-5"/>
        <severity value="error"/>
        <human value="Value set SHALL contain either a define, a compose, or an expansion element"/>
        <xpath value="exists(f:define) or exists(f:compose) or exists(f:expansion)"/>
      </constraint>
      <constraint>
        <key value="vsd-2"/>
        <severity value="error"/>
        <human value="A value set with only one import SHALL also have an include and/or an exclude unless the
         value set defines its own codes"/>
        <xpath value="not(exists(f:compose)) or (count(f:compose/f:import)!=1 or exists(f:compose/f:include)
         or exists(f:compose/f:exclude) or exists(f:define))"/>
      </constraint>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
      <mapping>
        <identity value="ihesdc"/>
        <map value="Form_Package//list_field"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.id"/>
      <short value="Logical id of this artefact"/>
      <definition value="The logical id of the resource, as used in the url for the resoure. Once assigned, this
       value never changes."/>
      <comments value="The only time that a resource does not have an id is when it is being submitted to the
       server using a create operation. Bundles always have an id, though it is usually a generated
       UUID."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="id"/>
      </type>
    </element>
    <element>
      <path value="ValueSet.meta"/>
      <short value="Metadata about the resource"/>
      <definition value="The metadata about the resource. This is content that is maintained by the infrastructure.
       Changes to the content may not always be associated with version changes to the resource."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Meta"/>
      </type>
    </element>
    <element>
      <path value="ValueSet.implicitRules"/>
      <short value="A set of rules under which this content was created"/>
      <definition value="A reference to a set of rules that were followed when the resource was constructed, and
       which must be understood when processing the content."/>
      <comments value="Asserting this rule set restricts the content to be only understood by a limited set of
       trading partners. This inherently limits the usefulness of the data in the long term.
       However the existing health eco-system is highly fractured, and not yet ready to define,
       collect, and exchange data in a generally computable sense. Wherever possible, implementers
       and/or specification writers should avoid using this element as much as possible."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="uri"/>
      </type>
      <isModifier value="true"/>
    </element>
    <element>
      <path value="ValueSet.language"/>
      <short value="Language of the resource content"/>
      <definition value="The base language in which the resource is written."/>
      <comments value="Language is provided to support indexing and accessibility (typically, services such as
       text to speech use the language tag). The html language tag in the narrative applies 
       to the narrative. The language tag on the resource may be used to specify the language
       of other presentations generated from the data in the resource  Not all the content has
       to be in the base language. The Resource.language should not be assumed to apply to the
       narrative automatically. If a language is specified, it should it also be specified on
       the div element in the html (see rules in HTML5 for information about the relationship
       between xml:lang and the html lang attribute)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <binding>
        <name value="Language"/>
        <isExtensible value="false"/>
        <conformance value="required"/>
        <description value="A human language"/>
        <referenceUri value="http://tools.ietf.org/html/bcp47"/>
      </binding>
    </element>
    <element>
      <path value="ValueSet.text"/>
      <short value="Text summary of the resource, for human interpretation"/>
      <definition value="A human-readable narrative that contains a summary of the resource, and may be used to
       represent the content of the resource to a human. The narrative need not encode all the
       structured data, but is required to contain sufficient detail to make it &quot;clinically
       safe&quot; for a human to just read the narrative. Resource definitions may define what
       content should be represented in the narrative to ensure clinical safety."/>
      <comments value="Contained resources do not have narrative. Resources that are not contained SHOULD have
       a narrative."/>
      <synonym value="narrative"/>
      <synonym value="html"/>
      <synonym value="xhtml"/>
      <synonym value="display"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Narrative"/>
      </type>
      <condition value="dom-1"/>
      <mapping>
        <identity value="rim"/>
        <map value="Act.text?"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.contained"/>
      <short value="Contained, inline Resources"/>
      <definition value="These resources do not have an independent existence apart from the resource that contains
       them - they cannot be identified independently, and nor can they have their own independent
       transaction scope."/>
      <comments value="This should never be done when the content can be identified properly, as once identification
       is lost, it is extremely difficult (and context dependent) to restore it again."/>
      <synonym value="inline resources"/>
      <synonym value="anonymous resources"/>
      <synonym value="contained resources"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Resource"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.extension"/>
      <slicing>
        <discriminator value="url"/>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource. In order to make the use of extensions safe and manageable, there is
       a strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.extension"/>
      <name value="styleSensitive"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource. In order to make the use of extensions safe and manageable, there is
       a strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/ExtensionDefinition/styleSensitive"/>
      </type>
      <mustSupport value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
      <mapping>
        <identity value="ihesdc"/>
        <map value="N/A (new requirement)"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.extension"/>
      <name value="category"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource. In order to make the use of extensions safe and manageable, there is
       a strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/ExtensionDefinition/valueset-category"/>
      </type>
      <mustSupport value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
      <mapping>
        <identity value="ihesdc"/>
        <map value="N/A (new requirement)"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource, and that modifies the understanding of the element that contains it.
       Usually modifier elements provide negation or qualification. In order to make the use
       of extensions safe and manageable, there is a strict set of governance applied to the
       definition and use of extensions. Though any implementer is allowed to define an extension,
       there is a set of requirements that SHALL be met as part of the definition of the extension.
       Applications processing a resource are required to check for modifier extensions."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.url"/>
      <short value="Globally unique logical id for  value set"/>
      <definition value="The uri that is used to identify this value set when it is referenced in a specification,
       model, design or an instance (should be globally unique URI, and an be urn:uuid: or urn:oid:)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="uri"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.identifier"/>
      <short value="Additional identifier for the value set (v2 / CDA)"/>
      <definition value="Formal identifier that is used to identify this value set when it is represented in other
       formats, or referenced in a specification, model, design or an instance."/>
      <comments value="Typically, this is used for values that can go in a v3 II data type."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Identifier"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="define.xml2.0"/>
        <map value="Identifier part"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.version"/>
      <short value="Logical id for this version of the value set"/>
      <definition value="The identifier that is used to identify this version of the value set when it is referenced
       in a specification, model, design or instance. This is an arbitrary value managed by the
       profile author manually and the value should be a timestamp."/>
      <comments value="There may be multiple resource versions of the value set that have the same identifier."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.name"/>
      <short value="Informal name for this value set"/>
      <definition value="A free text natural language name describing the value set."/>
      <comments value="The name is not expected to be unique. A name should be provided unless the value set
       is a contained resource (e.g. an anonymous value set in a profile). Most registries will
       require a name."/>
      <requirements value="Support human navigation."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.immutable"/>
      <short value="Indicates whether or not any change to the content logical definition may occur"/>
      <definition value="If this is set to 'true', then no new versions of the content logical definition can be
       created.  Note: Other metadata might still change."/>
      <comments value="Normally immutability is set to 'false', which is the default assumption if it is not
       populated.  Note that the implication is that if this is set to 'true', there may be only
       one Value Set Version for this Definition. Immutability tends to be set to 'true' in one
       of two cases: - Where the value set, by the nature of its usage, cannot change.  For example
       &quot;All specializations of ACT in ActClassCode&quot; - Where there's no safe way to
       express the &quot;Purpose&quot; such that someone else could safely make changes to the
       value set definition Source workflow control must guarantee that the same URI always yields
       the same definition."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="boolean"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="ValueSet.publisher"/>
      <short value="Name of the publisher (Organization or individual)"/>
      <definition value="The name of the individual or organization that published the value set."/>
      <comments value="Usually an organization, but may be an individual. This item SHOULD be populated unless
       the information is available from context."/>
      <requirements value="Helps establish the &quot;authority/credibility&quot; of the value set.  May also allow
       for contact."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="ValueSet.contact"/>
      <short value="Contact details of the publisher"/>
      <definition value="Contacts to assist a user in finding and communicating with the publisher."/>
      <comments value="May be a web site, an email address, a telephone number (tel:), etc."/>
      <min value="0"/>
      <max value="*"/>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="ValueSet.contact.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="id"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.contact.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. In order to make the use of extensions safe and manageable, there is a
       strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.contact.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element, and that modifies the understanding of the element that contains it. Usually
       modifier elements provide negation or qualification. In order to make the use of extensions
       safe and manageable, there is a strict set of governance applied to the definition and
       use of extensions. Though any implementer is allowed to define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension. Applications
       processing a resource are required to check for modifier extensions."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <synonym value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.contact.name"/>
      <short value="Name of a individual to contact"/>
      <definition value="The name of an individual to contact regarding the value set."/>
      <comments value="If there is no named individual, the telecom is for the organization as a whole."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="ValueSet.contact.telecom"/>
      <short value="Contact details for individual or publisher"/>
      <definition value="Contact details for individual (if a name was provided) or the publisher."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="ContactPoint"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="ValueSet.description"/>
      <short value="Human language description of the value set"/>
      <definition value="A free text natural language description of the use of the value set - reason for definition,
       &quot;the semantic space&quot; to be included in the value set, conditions of use, etc.
       The description may include a list of expected usages for the value set and can also describe
       the approach taken to build the value set."/>
      <comments value="The description is not intended to describe the semantics of the Value Set - there are
       no intrinsic semantics separate from the codes contained in its expansion. The description
       should capture its intended use, which is needed for ensuring integrity for its use in
       models across future changes. . A description should be provided unless the value set
       is a contained resource (e.g. an anonymous value set in a profile). Most registries will
       require a description."/>
      <requirements value="Human understandability."/>
      <synonym value="Scope"/>
      <synonym value="Purpose"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.requirements"/>
      <short value="Why is this needed?"/>
      <definition value="Explains why this value set is needed and why it's been constrained as it has."/>
      <comments value="This element does not describe the usage of the value set (that's done in comments), rather
       it's for traceability of *why* the element is either needed or why the constraints exist
       as they do.  This may be used to point to source materials or specifications that drove
       the structure of this data element."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
    </element>
    <element>
      <path value="ValueSet.copyright"/>
      <short value="Use and/or Publishing restrictions"/>
      <definition value="A copyright statement relating to the value set and/or its contents. Copyright statements
       are generally legal restrictions on the use and publishing of the value set."/>
      <comments value="Frequently, the copyright differs between the value set, and codes that are included.
       The copyright statement should clearly differentiate between these when required."/>
      <synonym value="License"/>
      <synonym value="Restrictions"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
    </element>
    <element>
      <path value="ValueSet.status"/>
      <short value="draft | active | retired"/>
      <definition value="The status of the value set."/>
      <comments value="Allows filtering of valuesets that are appropriate for use vs. not."/>
      <requirements value="Identify when/if the value set should be used."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <binding>
        <name value="ValueSetStatus"/>
        <isExtensible value="false"/>
        <conformance value="required"/>
        <description value="The lifecycle status of a Value Set or Concept Map"/>
        <referenceReference>
          <reference value="http://hl7.org/fhir/vs/valueset-status"/>
        </referenceReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.experimental"/>
      <short value="If for testing purposes, not real usage"/>
      <definition value="This valueset was authored for testing purposes (or education/evaluation/marketing), and
       is not intended to be used for genuine usage."/>
      <comments value="Allows filtering of valuesets that are appropriate for use vs. not."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="boolean"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="ValueSet.extensible"/>
      <short value="Whether this is intended to be used with an extensible binding"/>
      <definition value="Whether this is intended to be used with an extensible binding or not."/>
      <requirements value="It is not required to say whether this intent applies."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="boolean"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="ValueSet.date"/>
      <short value="Date for given status"/>
      <definition value="The date that the value set status was last changed."/>
      <comments value="Note that this is not the same as the resource last-modified-date, since the resource
       may be a secondary representation of the value set."/>
      <requirements value="Need to know when a value set was first legal for use or became withdrawn or replaced."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="dateTime"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.stableDate"/>
      <short value="Fixed date for the version of all referenced code systems and value sets"/>
      <definition value="If a Stability Date is expanded by evaluating the Content Logical Definition using the
       current version of all referenced code system(s) and value sets as of the Stability Date."/>
      <comments value="With a defined Stability Date the value set is considered &quot;Static&quot;.  Otherwise,
       the value set is considered to be &quot;Dynamic&quot; and may have different expansions
       as underlying code systems and/or value sets evolve."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="date"/>
      </type>
    </element>
    <element>
      <path value="ValueSet.define"/>
      <short value="When value set defines its own codes"/>
      <definition value="When value set defines its own codes."/>
      <min value="0"/>
      <max value="1"/>
      <condition value="vsd-5"/>
      <constraint>
        <key value="vsd-8"/>
        <severity value="error"/>
        <human value="Codes must be unique"/>
        <xpath value="count(descendant::f:concept)=count(distinct-values(descendant::f:concept/f:code/@value))"/>
      </constraint>
      <constraint>
        <key value="vsd-3"/>
        <severity value="error"/>
        <human value="Within a code system definition, all the codes SHALL be unique"/>
        <xpath value="count(distinct-values(descendant::f:concept/f:code/@value))=count(descendant::f:concept)"/>
      </constraint>
      <mustSupport value="true"/>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="ValueSet.define.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="id"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.define.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. In order to make the use of extensions safe and manageable, there is a
       strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.define.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element, and that modifies the understanding of the element that contains it. Usually
       modifier elements provide negation or qualification. In order to make the use of extensions
       safe and manageable, there is a strict set of governance applied to the definition and
       use of extensions. Though any implementer is allowed to define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension. Applications
       processing a resource are required to check for modifier extensions."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <synonym value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.define.system"/>
      <short value="URI to identify the code system"/>
      <definition value="URI to identify the code system."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="uri"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="ValueSet.define.version"/>
      <short value="Version of this system"/>
      <definition value="The version of this code system that defines the codes. Note that the version is optional
       because a well maintained code system does not suffer from versioning, and therefore the
       version does not need to be maintained. However many code systems are not well maintained,
       and the version needs to be defined and tracked."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="ValueSet.define.caseSensitive"/>
      <short value="If code comparison is case sensitive"/>
      <definition value="If code comparison is case sensitive when codes within this system are compared to each
       other."/>
      <comments value="If this value is missing, then it is not specified whether a code system is case sensitive
       or not. When the rule is not known, Postel's law should be followed: produce codes with
       the correct case, and accept codes in any case. This element is primarily provided to
       support validation software."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="boolean"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="ValueSet.define.concept"/>
      <name value="concept"/>
      <short value="Concepts in the code system"/>
      <definition value="Concepts in the code system."/>
      <min value="0"/>
      <max value="*"/>
      <mustSupport value="true"/>
      <mapping>
        <identity value="ihesdc"/>
        <map value="list_item"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.define.concept.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="id"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.define.concept.extension"/>
      <slicing>
        <discriminator value="url"/>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. In order to make the use of extensions safe and manageable, there is a
       strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.define.concept.extension"/>
      <name value="conceptLabel"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. In order to make the use of extensions safe and manageable, there is a
       strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/ExtensionDefinition/valueset-label"/>
      </type>
      <mustSupport value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="ihesdc"/>
        <map value="item_number/label"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.define.concept.extension.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="id"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.define.concept.extension.extension"/>
      <slicing>
        <discriminator value="url"/>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. In order to make the use of extensions safe and manageable, there is a
       strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.define.concept.extension.extension"/>
      <name value="conceptLabel.renderingStyle"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. In order to make the use of extensions safe and manageable, there is a
       strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/ExtensionDefinition/style"/>
      </type>
      <mustSupport value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="ihesdc"/>
        <map value="item_number/style"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.define.concept.extension.extension"/>
      <name value="conceptLabel.markup"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. In order to make the use of extensions safe and manageable, there is a
       strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/ExtensionDefinition/markup"/>
      </type>
      <mustSupport value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="ihesdc"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.define.concept.extension.url"/>
      <representation value="xmlAttr"/>
      <short value="identifies the meaning of the extension"/>
      <definition value="Source of the definition for the extension code - a logical name or a URL."/>
      <comments value="The definition may point directly to a computable or human-readable definition of the
       extensibility codes, or it may be a logical URI as declared in some other specification.
       The definition should be version specific.  This will ideally be the URI for the Resource
       Profile defining the extension, with the code for the extension after a #."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="uri"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.define.concept.extension.value[x]"/>
      <short value="Value of extension"/>
      <definition value="Value of extension - may be a resource or one of a constrained set of the data types (see
       Extensibility in the spec for list)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="*"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.define.concept.extension"/>
      <name value="conceptConceptOrder"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. In order to make the use of extensions safe and manageable, there is a
       strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/ExtensionDefinition/valueset-conceptOrder"/>
      </type>
      <mustSupport value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="ihesdc"/>
        <map value="list_item_order"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.define.concept.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element, and that modifies the understanding of the element that contains it. Usually
       modifier elements provide negation or qualification. In order to make the use of extensions
       safe and manageable, there is a strict set of governance applied to the definition and
       use of extensions. Though any implementer is allowed to define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension. Applications
       processing a resource are required to check for modifier extensions."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <synonym value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.define.concept.code"/>
      <short value="Code that identifies concept"/>
      <definition value="Code that identifies concept."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <mustSupport value="true"/>
      <mapping>
        <identity value="ihesdc"/>
        <map value="value"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.define.concept.abstract"/>
      <short value="If this code is not for use as a real concept"/>
      <definition value="If this code is not for use as a real concept."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="boolean"/>
      </type>
      <defaultValueBoolean value="false"/>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="ValueSet.define.concept.display"/>
      <short value="Text to Display to the user"/>
      <definition value="Text to Display to the user."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <mustSupport value="true"/>
      <mapping>
        <identity value="ihesdc"/>
        <map value="item_prompt"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.define.concept.display.extension"/>
      <slicing>
        <discriminator value="url"/>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource. In order to make the use of extensions safe and manageable, there is
       a strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
    </element>
    <element>
      <path value="ValueSet.define.concept.display.extension"/>
      <name value="conceptDisplayLabel.renderingStyle"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource. In order to make the use of extensions safe and manageable, there is
       a strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/ExtensionDefinition/style"/>
      </type>
      <mustSupport value="false"/>
    </element>
    <element>
      <path value="ValueSet.define.concept.display.extension"/>
      <name value="conceptDisplayLabel.markup"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource. In order to make the use of extensions safe and manageable, there is
       a strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/ExtensionDefinition/markup"/>
      </type>
      <mustSupport value="false"/>
      <mapping>
        <identity value="ihesdc"/>
        <map value="item_prompt_html"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.define.concept.display.value"/>
      <representation value="xmlAttr"/>
      <short value="Primitive value for string"/>
      <definition value="The actual value"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="xsd:string"/>
      </type>
    </element>
    <element>
      <path value="ValueSet.define.concept.definition"/>
      <short value="Formal Definition"/>
      <definition value="The formal definition of the concept. Formal definitions are not required, because of
       the prevalence of legacy systems without them, but they are highly recommended, as without
       them there is no formal meaning associated with the concept."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <mustSupport value="true"/>
      <mapping>
        <identity value="ihesdc"/>
        <map value="value_meaning/label"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.define.concept.designation"/>
      <name value="designation"/>
      <short value="Additional representations for the concept"/>
      <definition value="Additional representations for the concept - other languages, aliases, specialised purposes,
       used for particular purposes, etc."/>
      <requirements value="many concept definition systems support mltiple representations, in multiple languages,
       and for mltiple purposes."/>
      <min value="0"/>
      <max value="*"/>
    </element>
    <element>
      <path value="ValueSet.define.concept.designation.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="id"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.define.concept.designation.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. In order to make the use of extensions safe and manageable, there is a
       strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.define.concept.designation.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element, and that modifies the understanding of the element that contains it. Usually
       modifier elements provide negation or qualification. In order to make the use of extensions
       safe and manageable, there is a strict set of governance applied to the definition and
       use of extensions. Though any implementer is allowed to define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension. Applications
       processing a resource are required to check for modifier extensions."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <synonym value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.define.concept.designation.language"/>
      <short value="Language of the designation"/>
      <definition value="The language this designation is defined for."/>
      <comments value="In the absense of a language, the resource language applies."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <binding>
        <name value="Language"/>
        <isExtensible value="false"/>
        <conformance value="required"/>
        <description value="A human language"/>
        <referenceUri value="http://tools.ietf.org/html/bcp47"/>
      </binding>
    </element>
    <element>
      <path value="ValueSet.define.concept.designation.use"/>
      <short value="Details how this designation would be used"/>
      <definition value="A code that details how this designation would be used."/>
      <comments value="if no use is provided, the designation can be assumed to be suitable for general display
       to a human user."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Coding"/>
      </type>
      <binding>
        <name value="ConceptDesignationUse"/>
        <isExtensible value="true"/>
        <conformance value="preferred"/>
        <description value="Details of how a designation would be used"/>
        <referenceReference>
          <reference value="http://hl7.org/fhir/vs/designation-use"/>
        </referenceReference>
      </binding>
    </element>
    <element>
      <path value="ValueSet.define.concept.designation.value"/>
      <short value="The text value for this designation"/>
      <definition value="The text value for this designation."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
    </element>
    <element>
      <path value="ValueSet.define.concept.concept"/>
      <short value="Child Concepts (is-a / contains)"/>
      <definition value="Child Concepts (is-a / contains)."/>
      <min value="0"/>
      <max value="*"/>
      <nameReference value="concept"/>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="ValueSet.compose"/>
      <short value="When value set includes codes from elsewhere"/>
      <definition value="When value set includes codes from elsewhere."/>
      <min value="0"/>
      <max value="1"/>
      <condition value="vsd-5"/>
      <constraint>
        <key value="vsd-1"/>
        <severity value="error"/>
        <human value="A value set composition SHALL have an include or an import"/>
        <xpath value="exists(f:include) or exists(f:import)"/>
      </constraint>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="ValueSet.compose.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="id"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.compose.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. In order to make the use of extensions safe and manageable, there is a
       strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.compose.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element, and that modifies the understanding of the element that contains it. Usually
       modifier elements provide negation or qualification. In order to make the use of extensions
       safe and manageable, there is a strict set of governance applied to the definition and
       use of extensions. Though any implementer is allowed to define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension. Applications
       processing a resource are required to check for modifier extensions."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <synonym value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.compose.import"/>
      <short value="Import the contents of another value set"/>
      <definition value="Includes the contents of the referenced value set as a part of the contents of this value
       set."/>
      <comments value="The value set URI is either a logical reference to a defined value set such as a SNOMED
       CT reference set, or a literal reference to a value set definition (not an expansion).
       If the reference is a logical one, it may not reference a actual FHIR value set resource;
       in this case, the referenced definition of a set of coded values needs to be clear about
       how versions are resolved."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="uri"/>
      </type>
      <condition value="vsd-1"/>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.compose.include"/>
      <name value="include"/>
      <short value="Include one or more codes from a code system"/>
      <definition value="Include one or more codes from a code system."/>
      <comments value="If there are no codes or filters, the entire code system is included. Note that the set
       of codes hat are included may contain abstract codes."/>
      <min value="0"/>
      <max value="*"/>
      <condition value="vsd-1"/>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.compose.include.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="id"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.compose.include.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. In order to make the use of extensions safe and manageable, there is a
       strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.compose.include.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element, and that modifies the understanding of the element that contains it. Usually
       modifier elements provide negation or qualification. In order to make the use of extensions
       safe and manageable, there is a strict set of governance applied to the definition and
       use of extensions. Though any implementer is allowed to define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension. Applications
       processing a resource are required to check for modifier extensions."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <synonym value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.compose.include.system"/>
      <short value="The system the codes come from"/>
      <definition value="The code system from which the selected codes come from."/>
      <comments value="See *Coding.system* for further documentation."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="uri"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
      <mapping>
        <identity value="define.xml2.0"/>
        <map value="ODM/Study/MetaDataVersion/CodeList/ExternalCodeList/Href"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.compose.include.version"/>
      <short value="Specific version of the code system referred to"/>
      <definition value="The version of the code system that the codes are selected from."/>
      <comments value="This is used when selecting the descendents of a concept - they may change between versions.
       If no version is specified, then the exact contents of the value set may not be known
       until a context of use binds it to a particular version."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
      <mapping>
        <identity value="define.xml2.0"/>
        <map value="ODM/Study/MetaDataVersion/CodeList/ExternalCodeList/Version"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.compose.include.concept"/>
      <short value="A concept defined in the system"/>
      <definition value="Specifies a concept to be included or excluded."/>
      <comments value="The list of concepts is considered ordered, though the order may not have any particular
       significance. Typically, the order an an expansion follows that defined in the compose."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="code"/>
      </type>
      <mustSupport value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
      <mapping>
        <identity value="ihesdc"/>
        <map value="list_item/value"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.compose.include.concept.extension"/>
      <slicing>
        <discriminator value="url"/>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource. In order to make the use of extensions safe and manageable, there is
       a strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
    </element>
    <element>
      <path value="ValueSet.compose.include.concept.extension"/>
      <name value="conceptConceptOrder"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource. In order to make the use of extensions safe and manageable, there is
       a strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/ExtensionDefinition/valueset-conceptOrder"/>
      </type>
      <mustSupport value="true"/>
      <mapping>
        <identity value="ihesdc"/>
        <map value="list_item/list_item_order"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.compose.include.concept.value"/>
      <representation value="xmlAttr"/>
      <short value="Primitive value for code"/>
      <definition value="Primitive value for code"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="xsd:string"/>
      </type>
    </element>
    <element>
      <path value="ValueSet.compose.include.concept.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="id"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.compose.include.concept.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. In order to make the use of extensions safe and manageable, there is a
       strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.compose.include.concept.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element, and that modifies the understanding of the element that contains it. Usually
       modifier elements provide negation or qualification. In order to make the use of extensions
       safe and manageable, there is a strict set of governance applied to the definition and
       use of extensions. Though any implementer is allowed to define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension. Applications
       processing a resource are required to check for modifier extensions."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <synonym value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.compose.include.concept.code"/>
      <short value="Code or expression from system"/>
      <definition value="Specifies a code for the concept to be included or excluded."/>
      <comments value="Expressions are allowed if defined by the underlying code system."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.compose.include.concept.display"/>
      <short value="Test to display for this code for this value set"/>
      <definition value="The text to display to the user for this concept in the context of this valueset. If no
       display is provided, then applications using the value set use the display specified for
       the code by the system."/>
      <comments value="The value set resource allows for an alternative display to be specified for when this
       concept is used in this particular value set. See notes in the value set narrative about
       the correct use of this element."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.compose.include.concept.designation"/>
      <short value="Additional representations for this valueset"/>
      <definition value="Additional representations for this concept when used in this value set - other languages,
       aliases, specialised purposes, used for particular purposes, etc."/>
      <min value="0"/>
      <max value="*"/>
      <nameReference value="designation"/>
    </element>
    <element>
      <path value="ValueSet.compose.include.filter"/>
      <short value="Select codes/concepts by their properties (including relationships)"/>
      <definition value="Select concepts by specify a matching criteria based on the properties (including relationships)
       defined by the system. If multiple filters are specified, they SHALL all be true."/>
      <comments value="Selecting codes by specifying filters based on properties is only possible where the underlying
       code system defines appropriate properties. Note that in some cases, the underlying code
       system defines the logical concepts but not the literal codes for the concepts. In such
       cases, the literal definitions may be provided by a third party."/>
      <min value="0"/>
      <max value="*"/>
      <mustSupport value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.compose.include.filter.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="id"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.compose.include.filter.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. In order to make the use of extensions safe and manageable, there is a
       strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.compose.include.filter.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element, and that modifies the understanding of the element that contains it. Usually
       modifier elements provide negation or qualification. In order to make the use of extensions
       safe and manageable, there is a strict set of governance applied to the definition and
       use of extensions. Though any implementer is allowed to define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension. Applications
       processing a resource are required to check for modifier extensions."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <synonym value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.compose.include.filter.property"/>
      <short value="A property defined by the code system"/>
      <definition value="A code that identifies a property defined in the code system."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <mustSupport value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.compose.include.filter.op"/>
      <short value="= | is-a | is-not-a | regex | in | not-in"/>
      <definition value="The kind of operation to perform as a part of the filter criteria."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <mustSupport value="true"/>
      <binding>
        <name value="FilterOperator"/>
        <isExtensible value="false"/>
        <conformance value="required"/>
        <description value="The kind of operation to perform as a part of a property based filter"/>
        <referenceReference>
          <reference value="http://hl7.org/fhir/vs/filter-operator"/>
        </referenceReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.compose.include.filter.value"/>
      <short value="Code from the system, or regex criteria"/>
      <definition value="The match value may be either a code defined by the system, or a string value which is
       used a regex match on the literal string of the property value."/>
      <comments value="Use regex matching with care - full regex matching on every SNOMED CT term is prohibitive,
       for example."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <mustSupport value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.compose.exclude"/>
      <short value="Explicitly exclude codes"/>
      <definition value="Exclude one or more codes from the value set."/>
      <comments value="Usually this is used to selectively exclude codes that were included by subsumption in
       the inclusions. Any display names specified for the codes are ignored."/>
      <min value="0"/>
      <max value="*"/>
      <nameReference value="include"/>
      <condition value="vsd-2"/>
      <mustSupport value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.expansion"/>
      <short value="Used when the value set is &quot;expanded&quot;"/>
      <definition value="A value set can also be &quot;expanded&quot;, where the value set is turned into a simple
       collection of enumerated codes. This element holds the expansion, if it has been performed."/>
      <comments value="Expansion is performed to produce a collection of codes that are ready to use for data
       entry or validation."/>
      <min value="0"/>
      <max value="1"/>
      <condition value="vsd-5"/>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="ValueSet.expansion.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="id"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.expansion.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. In order to make the use of extensions safe and manageable, there is a
       strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.expansion.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element, and that modifies the understanding of the element that contains it. Usually
       modifier elements provide negation or qualification. In order to make the use of extensions
       safe and manageable, there is a strict set of governance applied to the definition and
       use of extensions. Though any implementer is allowed to define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension. Applications
       processing a resource are required to check for modifier extensions."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <synonym value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.expansion.identifier"/>
      <short value="Uniquely identifies this expansion"/>
      <definition value="An identifier that uniquely identifies this expansion of the valueset. Systems may re-use
       the same identifier as long as the expansion and the definition remain the same, but are
       not required to do so."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Identifier"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="ValueSet.expansion.timestamp"/>
      <short value="Time valueset expansion happened"/>
      <definition value="The time at which the expansion was produced by the expanding system."/>
      <comments value="This SHOULD have be a fully populated instant, but in some circumstances, value sets are
       expanded by hand, of the expansion is published without that precision."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="dateTime"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="ValueSet.expansion.contains"/>
      <name value="contains"/>
      <short value="Codes in the value set"/>
      <definition value="The codes that are contained in the value set expansion."/>
      <min value="0"/>
      <max value="*"/>
      <constraint>
        <key value="vsd-9"/>
        <severity value="error"/>
        <human value="Must have a code if not abstract"/>
        <xpath value="exists(f:code) or (f:display/@value = 'true')"/>
      </constraint>
      <constraint>
        <key value="vsd-6"/>
        <severity value="error"/>
        <human value="SHALL have a code or a display"/>
        <xpath value="exists(f:code) or exists(f:display)"/>
      </constraint>
      <constraint>
        <key value="vsd-10"/>
        <severity value="error"/>
        <human value="Must have a system if a code is present"/>
        <xpath value="exists(f:system) or not(exists(f:code))"/>
      </constraint>
      <mustSupport value="true"/>
      <mapping>
        <identity value="ihesdc"/>
        <map value="list_item"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.expansion.contains.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="id"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.expansion.contains.extension"/>
      <slicing>
        <discriminator value="url"/>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. In order to make the use of extensions safe and manageable, there is a
       strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.expansion.contains.extension"/>
      <name value="expansionLabel"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. In order to make the use of extensions safe and manageable, there is a
       strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/ExtensionDefinition/valueset-label"/>
      </type>
      <mustSupport value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="ihesdc"/>
        <map value="item_number/label"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.expansion.contains.extension.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="id"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.expansion.contains.extension.extension"/>
      <slicing>
        <discriminator value="url"/>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. In order to make the use of extensions safe and manageable, there is a
       strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.expansion.contains.extension.extension"/>
      <name value="expansion.renderingStyle"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. In order to make the use of extensions safe and manageable, there is a
       strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/ExtensionDefinition/style"/>
      </type>
      <mustSupport value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="ihesdc"/>
        <map value="item_number/style"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.expansion.contains.extension.extension"/>
      <name value="expansion.markup"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. In order to make the use of extensions safe and manageable, there is a
       strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/ExtensionDefinition/markup"/>
      </type>
      <mustSupport value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="ihesdc"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.expansion.contains.extension.url"/>
      <representation value="xmlAttr"/>
      <short value="identifies the meaning of the extension"/>
      <definition value="Source of the definition for the extension code - a logical name or a URL."/>
      <comments value="The definition may point directly to a computable or human-readable definition of the
       extensibility codes, or it may be a logical URI as declared in some other specification.
       The definition should be version specific.  This will ideally be the URI for the Resource
       Profile defining the extension, with the code for the extension after a #."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="uri"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.expansion.contains.extension.value[x]"/>
      <short value="Value of extension"/>
      <definition value="Value of extension - may be a resource or one of a constrained set of the data types (see
       Extensibility in the spec for list)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="*"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.expansion.contains.extension"/>
      <name value="conceptConceptOrder"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. In order to make the use of extensions safe and manageable, there is a
       strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/ExtensionDefinition/valueset-conceptOrder"/>
      </type>
      <mustSupport value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="ihesdc"/>
        <map value="list_item_order"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.expansion.contains.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element, and that modifies the understanding of the element that contains it. Usually
       modifier elements provide negation or qualification. In order to make the use of extensions
       safe and manageable, there is a strict set of governance applied to the definition and
       use of extensions. Though any implementer is allowed to define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension. Applications
       processing a resource are required to check for modifier extensions."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <synonym value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.expansion.contains.system"/>
      <short value="System value for the code"/>
      <definition value="The system in which the code for this item in the expansion is defined."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="uri"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="ValueSet.expansion.contains.abstract"/>
      <short value="If user cannot select this entry"/>
      <definition value="If true, this entry is included in the expansion for navigational purposes, and the user
       cannot select the code directly as a proper value."/>
      <comments value="This shouldn't be understood to exclude its use for searchig (e..g by subsumption testing).
       The client should know whether it is appropriate for the user to select an abstract code
       or not."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="boolean"/>
      </type>
    </element>
    <element>
      <path value="ValueSet.expansion.contains.version"/>
      <short value="Version in which this code / display is defined"/>
      <definition value="The version of this code system that defined this code and/or display. This should only
       be used with code systems that do not enforce concept permanence."/>
      <comments value="The exact value of the version string is specified by the system from which the code is
       derived."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
    </element>
    <element>
      <path value="ValueSet.expansion.contains.code"/>
      <short value="Code - if blank, this is not a choosable code"/>
      <definition value="Code - if blank, this is not a choosable code."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <condition value="vsd-6"/>
      <mustSupport value="true"/>
      <mapping>
        <identity value="ihesdc"/>
        <map value="value"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.expansion.contains.display"/>
      <short value="User display for the concept"/>
      <definition value="User display for the concept."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <condition value="vsd-6"/>
      <mustSupport value="true"/>
      <mapping>
        <identity value="ihesdc"/>
        <map value="item_prompt"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.expansion.contains.display.extension"/>
      <slicing>
        <discriminator value="url"/>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource. In order to make the use of extensions safe and manageable, there is
       a strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
    </element>
    <element>
      <path value="ValueSet.expansion.contains.display.extension"/>
      <name value="expansionDisplay.renderingStyle"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource. In order to make the use of extensions safe and manageable, there is
       a strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/ExtensionDefinition/style"/>
      </type>
      <mustSupport value="false"/>
    </element>
    <element>
      <path value="ValueSet.expansion.contains.display.extension"/>
      <name value="expansionDisplay.markup"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource. In order to make the use of extensions safe and manageable, there is
       a strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <synonym value="extensions"/>
      <synonym value="user content"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/ExtensionDefinition/markup"/>
      </type>
      <mustSupport value="false"/>
      <mapping>
        <identity value="ihesdc"/>
        <map value="item_prompt_html"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.expansion.contains.display.value"/>
      <representation value="xmlAttr"/>
      <short value="Primitive value for string"/>
      <definition value="The actual value"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="xsd:string"/>
      </type>
    </element>
    <element>
      <path value="ValueSet.expansion.contains.contains"/>
      <short value="Codes contained in this concept"/>
      <definition value="Codes contained in this concept."/>
      <min value="0"/>
      <max value="*"/>
      <nameReference value="contains"/>
      <mustSupport value="true"/>
    </element>
  </snapshot>
  <differential>
    <element>
      <path value="ValueSet"/>
      <name value="StructuredDataCaptureValueSet"/>
      <min value="1"/>
      <max value="1"/>
      <mapping>
        <identity value="ihesdc"/>
        <map value="Form_Package//list_field"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.telecom"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="ContactPoint"/>
      </type>
    </element>
    <element>
      <path value="ValueSet.extension"/>
      <slicing>
        <discriminator value="url"/>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
    </element>
    <element>
      <path value="ValueSet.extension"/>
      <name value="styleSensitive"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/ExtensionDefinition/styleSensitive"/>
      </type>
      <mustSupport value="true"/>
      <mapping>
        <identity value="ihesdc"/>
        <map value="N/A (new requirement)"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.extension"/>
      <name value="category"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/ExtensionDefinition/valueset-category"/>
      </type>
      <mustSupport value="true"/>
      <mapping>
        <identity value="ihesdc"/>
        <map value="N/A (new requirement)"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.url"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="uri"/>
      </type>
    </element>
    <element>
      <path value="ValueSet.version"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
    </element>
    <element>
      <path value="ValueSet.name"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="ValueSet.immutable"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="boolean"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="ValueSet.publisher"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
    </element>
    <element>
      <path value="ValueSet.description"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
    </element>
    <element>
      <path value="ValueSet.copyright"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
    </element>
    <element>
      <path value="ValueSet.status"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="ValueSet.experimental"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="boolean"/>
      </type>
    </element>
    <element>
      <path value="ValueSet.extensible"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="boolean"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="ValueSet.date"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="dateTime"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="ValueSet.stableDate"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="date"/>
      </type>
    </element>
    <element>
      <path value="ValueSet.define"/>
      <min value="0"/>
      <max value="1"/>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="ValueSet.define.system"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="uri"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="ValueSet.define.version"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="ValueSet.define.caseSensitive"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="boolean"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="ValueSet.define.concept"/>
      <name value="concept"/>
      <min value="0"/>
      <max value="*"/>
      <mustSupport value="true"/>
      <mapping>
        <identity value="ihesdc"/>
        <map value="list_item"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.define.concept.extension"/>
      <slicing>
        <discriminator value="url"/>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
    </element>
    <element>
      <path value="ValueSet.define.concept.extension"/>
      <name value="conceptLabel"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/ExtensionDefinition/valueset-label"/>
      </type>
      <mustSupport value="true"/>
      <mapping>
        <identity value="ihesdc"/>
        <map value="item_number/label"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.define.concept.extension.extension"/>
      <slicing>
        <discriminator value="url"/>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
    </element>
    <element>
      <path value="ValueSet.define.concept.extension.extension"/>
      <name value="conceptLabel.renderingStyle"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/ExtensionDefinition/style"/>
      </type>
      <mustSupport value="false"/>
      <mapping>
        <identity value="ihesdc"/>
        <map value="item_number/style"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.define.concept.extension.extension"/>
      <name value="conceptLabel.markup"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/ExtensionDefinition/markup"/>
      </type>
      <mustSupport value="false"/>
      <mapping>
        <identity value="ihesdc"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.define.concept.extension"/>
      <name value="conceptConceptOrder"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/ExtensionDefinition/valueset-conceptOrder"/>
      </type>
      <mustSupport value="true"/>
      <mapping>
        <identity value="ihesdc"/>
        <map value="list_item_order"/>
      </mapping>
    </element>
    <element>
      <path value="ValueSet.define.concept.code"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <mustSupport value="true"/>
      <mapping>
        <identity value="ihesdc"/>
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        <code value="boolean"/>
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    <element>
      <path value="ValueSet.define.concept.display.extension"/>
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        <code value="Extension"/>
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    <element>
      <path value="ValueSet.define.concept.display.extension"/>
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        <code value="Extension"/>
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        <code value="string"/>
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        <code value="string"/>
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        <code value="code"/>
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        <identity value="ihesdc"/>
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    <element>
      <path value="ValueSet.compose.include.concept.display.extension"/>
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        <code value="code"/>
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        <code value="code"/>
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        <code value="Identifier"/>
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      <max value="*"/>
      <nameReference value="contains"/>
      <mustSupport value="true"/>
    </element>
  </differential>
</Profile>