STU 3 Candidate

This page is part of the FHIR Specification (v1.4.0: STU 3 Ballot 3). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions

StructureDefinition: GAO Alternate - XML

GAO Alternate

<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="gao-alternate"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      
      <h2>GAO Alternate</h2>
      
      <p>The alternate resource provides the results of an evaluation for alternative treatements
        that may be suggested by the decision support service.</p>
      
      <h3>Requirements</h3>
      
      <p>Similar to the result resource, the alternate resource enables the results of an evaluation
        to be returned. However, because the alternate is suggested by the decision support
         service,
        the constraints on what may appear are slightly different.</p>
    
    </div>
  </text>
  <url value="http://hl7.org/fhir/StructureDefinition/gao-alternate"/>
  <name value="GAO Alternate"/>
  <status value="draft"/>
  <date value="2015-09-22T20:02:49+10:00"/>
  <description value="The alternate resource provides the results of an evaluation for alternative treatements
   that may be suggested by the decision support service."/>
  <requirements value="Similar to the result resource, the alternate resource enables the results of an evaluation
   to be returned.  However, because the alternate is suggested by the decision support service,
   the constraints on what may appear are slightly different."/>
  <fhirVersion value="1.4.0"/>
  <kind value="resource"/>
  <abstract value="false"/>
  <baseType value="Basic"/>
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Basic"/>
  <derivation value="constraint"/>
  <snapshot>
    <element>
      <path value="Basic"/>
      <short value="Resource for non-supported content"/>
      <definition value="Basic is used for handling concepts not yet defined in FHIR, narrative-only resources
       that don't map to an existing resource, and custom resources not appropriate for inclusion
       in the FHIR specification."/>
      <alias value="Z-resource"/>
      <alias value="Extension-resource"/>
      <alias value="Custom-resource"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Basic"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Basic"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="Act, Entity or Role"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="infrastructure.structure"/>
      </mapping>
    </element>
    <element>
      <path value="Basic.id"/>
      <short value="Logical id of this artifact"/>
      <definition value="The logical id of the resource, as used in the URL for the resource. 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"/>
      <base>
        <path value="Resource.id"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="Basic.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"/>
      <base>
        <path value="Resource.meta"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Meta"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="Basic.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"/>
      <base>
        <path value="Resource.implicitRules"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="Basic.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"/>
      <base>
        <path value="Resource.language"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <binding>
        <strength value="required"/>
        <description value="A human language."/>
        <valueSetUri value="http://tools.ietf.org/html/bcp47"/>
      </binding>
    </element>
    <element>
      <path value="Basic.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."/>
      <alias value="narrative"/>
      <alias value="html"/>
      <alias value="xhtml"/>
      <alias value="display"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.text"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Narrative"/>
      </type>
      <condition value="dom-1"/>
      <mapping>
        <identity value="rim"/>
        <map value="Act.text?"/>
      </mapping>
    </element>
    <element>
      <path value="Basic.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."/>
      <alias value="inline resources"/>
      <alias value="anonymous resources"/>
      <alias value="contained resources"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.contained"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Resource"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="Basic.extension"/>
      <slicing>
        <discriminator value="url"/>
        <rules value="openAtEnd"/>
      </slicing>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
    </element>
    <element>
      <path value="Basic.extension"/>
      <name value="score"/>
      <label value="score"/>
      <short value="Extension"/>
      <definition value="An optional value which can be used to record a score associated with the evaluation process.
       "/>
      <comments value="The interpretation of this value may vary depending upon guidelines and Decision Support
       Service actors used. "/>
      <requirements value="This may be present to enable quality improvement efforts related to ordering."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/gao-extension-score"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="Basic.extension"/>
      <name value="period"/>
      <label value="period"/>
      <short value="Extension"/>
      <definition value="Indicates the period over which the evaluation is valid."/>
      <comments value="Not required when manually issued, required otherwise."/>
      <requirements value="This field SHALL be provided unless the evaluation was issued manually, in which case
       it is optional."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/gao-extension-period"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="Basic.extension"/>
      <name value="item"/>
      <label value="item"/>
      <short value="Extension"/>
      <definition value="Describes the services ordered."/>
      <requirements value="The services that are to be ordered SHALL be provided."/>
      <min value="1"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/gao-extension-item"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="Basic.extension"/>
      <name value="guideline"/>
      <label value="guideline"/>
      <short value="Extension"/>
      <definition value="A reference to the guidelines or policies under which the evaluation was created."/>
      <requirements value="This field SHALL be provided unless the evaluation was issued manually, in which case
       it is optional"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/gao-extension-guideline"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="Basic.extension"/>
      <name value="device"/>
      <label value="device"/>
      <short value="Extension"/>
      <definition value="A reference to the Device resource describing the Decision Support Service Actor."/>
      <requirements value="This field SHALL be provided unless the evaluation was issued manually, in which case
       it is optional.  This SHALL be a reference to one of the Devices specified in the dss
       parameter."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/gao-extension-device"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="Basic.extension"/>
      <name value="practitioner"/>
      <label value="practitioner"/>
      <short value="Extension"/>
      <definition value="An identifier representing the ordering practitioner."/>
      <requirements value="This SHALL be provided unless the evaluation was issued manually, in which case it is
       optional."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/gao-extension-practitioner"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="Basic.extension"/>
      <name value="signature"/>
      <label value="signature"/>
      <short value="Extension"/>
      <definition value="A digital signature over this resource"/>
      <requirements value="This MAY be provided."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/gao-extension-signature"/>
      </type>
    </element>
    <element>
      <path value="Basic.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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="Basic.identifier"/>
      <short value="Business identifier"/>
      <definition value="Identifier assigned to the resource for business purposes, outside the context of FHIR."/>
      <requirements value="This is a business identifier associated with the evaluation for the order. It is a unique
       identifier issued by the evaluator associated with this transaction. An identifier SHALL
       be provided unless the code is “incomplete�, “cannot be evaluated� or “not covered�. Note
       that this identifier may be associated with multiple evaluations. "/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Basic.identifier"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="./identifier"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="id"/>
      </mapping>
    </element>
    <element>
      <path value="Basic.code"/>
      <short value="Kind of Resource"/>
      <definition value="Identifies the 'type' of resource - equivalent to the resource name for other resources."/>
      <comments value="Because resource references will only be able to indicate 'Basic', the type of reference
       will need to be specified in a Profile identified as part of the resource.  Refer to the
       resource notes section for information on appropriate terminologies for this code."/>
      <requirements value="Must be able to distinguish different types of &quot;basic&quot; resources."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Basic.code"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <binding>
        <strength value="example"/>
        <description value="Codes for identifying types of resources not yet defined by FHIR"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/gao-result"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="./code"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="what"/>
      </mapping>
    </element>
    <element>
      <path value="Basic.subject"/>
      <short value="Identifies the focus of this resource"/>
      <definition value="Identifies the patient, practitioner, device or any other resource that is the &quot;focus&quot;
       of this resource."/>
      <comments value="Optional as not all resources potential resources will have subjects.  Resources associated
       with multiple subjects can handle this via extension."/>
      <requirements value="Needed for partitioning the resource by Patient."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Basic.subject"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/gao-order"/>
        <aggregation value="contained"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="./participation[typeCode='SBJ'] (possibly through a ControlAct and Role)"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.focus"/>
      </mapping>
    </element>
    <element>
      <path value="Basic.created"/>
      <short value="When created"/>
      <definition value="Identifies when the resource was first created."/>
      <requirements value="Allows ordering resource instances by time."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Basic.created"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="date"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="./participation[typeCode='AUT']/time (possibly through a ControlAct and Role)"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="when.recorded"/>
      </mapping>
    </element>
    <element>
      <path value="Basic.author"/>
      <short value="Who created"/>
      <definition value="Indicates who was responsible for creating the resource instance."/>
      <requirements value="Needed for partitioning the resource."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Basic.author"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="./participation[typeCode='SUB'] (possibly through a ControlAct and Role)"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="who.author"/>
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element>
      <path value="Basic"/>
      <short value="Resource for non-supported content"/>
      <definition value="Basic is used for handling concepts not yet defined in FHIR, narrative-only resources
       that don't map to an existing resource, and custom resources not appropriate for inclusion
       in the FHIR specification."/>
      <alias value="Z-resource"/>
      <alias value="Extension-resource"/>
      <alias value="Custom-resource"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Basic"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="Basic.extension"/>
      <slicing>
        <discriminator value="url"/>
        <rules value="openAtEnd"/>
      </slicing>
    </element>
    <element>
      <path value="Basic.extension"/>
      <name value="score"/>
      <label value="score"/>
      <definition value="An optional value which can be used to record a score associated with the evaluation process.
       "/>
      <comments value="The interpretation of this value may vary depending upon guidelines and Decision Support
       Service actors used. "/>
      <requirements value="This may be present to enable quality improvement efforts related to ordering."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/gao-extension-score"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="Basic.extension"/>
      <name value="period"/>
      <label value="period"/>
      <definition value="Indicates the period over which the evaluation is valid."/>
      <comments value="Not required when manually issued, required otherwise."/>
      <requirements value="This field SHALL be provided unless the evaluation was issued manually, in which case
       it is optional."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/gao-extension-period"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="Basic.extension"/>
      <name value="item"/>
      <label value="item"/>
      <definition value="Describes the services ordered."/>
      <requirements value="The services that are to be ordered SHALL be provided."/>
      <min value="1"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/gao-extension-item"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="Basic.extension"/>
      <name value="guideline"/>
      <label value="guideline"/>
      <definition value="A reference to the guidelines or policies under which the evaluation was created."/>
      <requirements value="This field SHALL be provided unless the evaluation was issued manually, in which case
       it is optional"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/gao-extension-guideline"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="Basic.extension"/>
      <name value="device"/>
      <label value="device"/>
      <definition value="A reference to the Device resource describing the Decision Support Service Actor."/>
      <requirements value="This field SHALL be provided unless the evaluation was issued manually, in which case
       it is optional.  This SHALL be a reference to one of the Devices specified in the dss
       parameter."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/gao-extension-device"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="Basic.extension"/>
      <name value="practitioner"/>
      <label value="practitioner"/>
      <definition value="An identifier representing the ordering practitioner."/>
      <requirements value="This SHALL be provided unless the evaluation was issued manually, in which case it is
       optional."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/gao-extension-practitioner"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="Basic.extension"/>
      <name value="signature"/>
      <label value="signature"/>
      <definition value="A digital signature over this resource"/>
      <requirements value="This MAY be provided."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/gao-extension-signature"/>
      </type>
    </element>
    <element>
      <path value="Basic.identifier"/>
      <short value="Business identifier"/>
      <definition value="Identifier assigned to the resource for business purposes, outside the context of FHIR."/>
      <requirements value="This is a business identifier associated with the evaluation for the order. It is a unique
       identifier issued by the evaluator associated with this transaction. An identifier SHALL
       be provided unless the code is “incomplete�, “cannot be evaluated� or “not covered�. Note
       that this identifier may be associated with multiple evaluations. "/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Identifier"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="Basic.code"/>
      <short value="Kind of Resource"/>
      <definition value="Identifies the 'type' of resource - equivalent to the resource name for other resources."/>
      <comments value="Because resource references will only be able to indicate 'Basic', the type of reference
       will need to be specified in a Profile identified as part of the resource.  Refer to the
       resource notes section for information on appropriate terminologies for this code."/>
      <requirements value="Must be able to distinguish different types of &quot;basic&quot; resources."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <binding>
        <strength value="example"/>
        <description value="Codes for identifying types of resources not yet defined by FHIR"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/gao-result"/>
        </valueSetReference>
      </binding>
    </element>
    <element>
      <path value="Basic.subject"/>
      <short value="Identifies the focus of this resource"/>
      <definition value="Identifies the patient, practitioner, device or any other resource that is the &quot;focus&quot;
       of this resource."/>
      <comments value="Optional as not all resources potential resources will have subjects.  Resources associated
       with multiple subjects can handle this via extension."/>
      <requirements value="Needed for partitioning the resource by Patient."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/gao-order"/>
        <aggregation value="contained"/>
      </type>
      <isSummary value="true"/>
    </element>
  </differential>
</StructureDefinition>