This page is part of the FHIR Specification (v0.0.82: DSTU 1). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

Documentreference.profile.xml

Profile for documentreference

Raw XML

<Profile xmlns="http://hl7.org/fhir">
  <text>
    <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><pre>
&lt;<a class="dict" href="documentreference-definitions.html#DocumentReference" title="A reference to a document."><b>DocumentReference</b></a> xmlns=&quot;http://hl7.org/fhir&quot;&gt; <span style="float: right"><a href="formats.html" title="Documentation for this format"><img alt="doco" src="help.png"/></a></span>
 &lt;!-- from <a href="resources.html">Resource</a>: <a href="extensibility.html">extension</a>, <a href="extensibility.html#modifierExtension">modifierExtension</a>, language, <a href="narrative.html#Narrative">text</a>, and <a href="references.html#contained">contained</a> --&gt;
 &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.masterIdentifier" title="Document identifier as assigned by the source of the document. This identifier is specific
         to this version of the document. This unique identifier may be used elsewhere to identify
         this version of the document."><b>masterIdentifier</b></a>&gt;<span style="color: Gray">&lt;!--</span> <span style="color: brown"><b>1..1</b></span> <span style="color: darkgreen"><a href="datatypes.html#Identifier">Identifier</a></span> <span style="color: navy">Master Version Specific Identifier</span><span style="color: Gray"> --&gt;</span>&lt;/masterIdentifier&gt;
 &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.identifier" title="Other identifiers associated with the document, including version independent, source
         record and workflow related identifiers."><b>identifier</b></a>&gt;<span style="color: Gray">&lt;!--</span> <span style="color: brown"><b>0..*</b></span> <span style="color: darkgreen"><a href="datatypes.html#Identifier">Identifier</a></span> <span style="color: navy">Other identifiers for the document</span><span style="color: Gray"> --&gt;</span>&lt;/identifier&gt;
 &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.subject" title="Who or what the document is about. The document can be about a person, (patient or healthcare
         practitioner), a device (I.e. machine) or even a group of subjects (such as a document
         about a herd of farm animals, or a set of patients that share a common exposure)."><b>subject</b></a>&gt;<span style="color: Gray">&lt;!--</span> <span style="color: brown"><b>1..1</b></span> <span style="color: darkgreen"><a href="references.html#Resource">Resource</a>(<a href="patient.html#Patient">Patient</a>|<a href="practitioner.html#Practitioner">Practitioner</a>|<a href="group.html#Group">Group</a>|<a href="device.html#Device">Device</a>)</span> <span style="color: navy">
     Who|what is the subject of the document</span><span style="color: Gray"> --&gt;</span>&lt;/subject&gt;
 &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.type" title="Specifies the particular kind of document (e.g. Patient Summary, Discharge Summary, Prescription,
         etc.)."><b>type</b></a>&gt;<span style="color: Gray">&lt;!--</span> <span style="color: brown"><b>1..1</b></span> <span style="color: darkgreen"><a href="datatypes.html#CodeableConcept">CodeableConcept</a></span> <span style="color: navy"><a href="valueset-doc-codes.html" style="color: navy">What kind of document this is (LOINC if possible)</a></span><span style="color: Gray"> --&gt;</span>&lt;/type&gt;
 &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.class" title="A categorization for the type of the document. This may be implied by or derived from
         the code specified in the Document Type."><b>class</b></a>&gt;<span style="color: Gray">&lt;!--</span> <span style="color: brown"><b>0..1</b></span> <span style="color: darkgreen"><a href="datatypes.html#CodeableConcept">CodeableConcept</a></span> <span style="color: navy"><a href="valueset-xds-typecodes.html" style="color: navy">Categorization of Document</a></span><span style="color: Gray"> --&gt;</span>&lt;/class&gt;
 &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.author" title="Identifies who is responsible for adding the information to the document."><b>author</b></a>&gt;<span style="color: Gray">&lt;!--</span> <span style="color: brown"><b>1..*</b></span> <span style="color: darkgreen"><a href="references.html#Resource">Resource</a>(<a href="practitioner.html#Practitioner">Practitioner</a>|<a href="device.html#Device">Device</a>|<a href="patient.html#Patient">Patient</a>|<a href="relatedperson.html#RelatedPerson">RelatedPerson</a>)</span> <span style="color: navy">
     Who and/or what authored the document</span><span style="color: Gray"> --&gt;</span>&lt;/author&gt;
 &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.custodian" title="Identifies the organization or group who is responsible for ongoing maintenance of and
         access to the document."><b>custodian</b></a>&gt;<span style="color: Gray">&lt;!--</span> <span style="color: brown"><b>0..1</b></span> <span style="color: darkgreen"><a href="references.html#Resource">Resource</a>(<a href="organization.html#Organization">Organization</a>)</span> <span style="color: navy">Org which maintains the document</span><span style="color: Gray"> --&gt;</span>&lt;/custodian&gt;
 &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.policyManager" title="A reference to a domain or server that manages policies under which the document is accessed
         and/or made available."><b>policyManager</b></a> value=&quot;[<span style="color: darkgreen"><a href="datatypes.html#uri">uri</a></span>]&quot;/&gt;<span style="color: Gray">&lt;!--</span> <span style="color: brown"><b>0..1</b></span> <span style="color: navy">Manages access policies for the document</span><span style="color: Gray"> --&gt;</span>
 &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.authenticator" title="Which person or organization authenticates that this document is valid."><b>authenticator</b></a>&gt;<span style="color: Gray">&lt;!--</span> <span style="color: brown"><b>0..1</b></span> <span style="color: darkgreen"><a href="references.html#Resource">Resource</a>(<a href="practitioner.html#Practitioner">Practitioner</a>|<a href="organization.html#Organization">Organization</a>)</span> <span style="color: navy">
     Who/What authenticated the document</span><span style="color: Gray"> --&gt;</span>&lt;/authenticator&gt;
 &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.created" title="When the document was created."><b>created</b></a> value=&quot;[<span style="color: darkgreen"><a href="datatypes.html#dateTime">dateTime</a></span>]&quot;/&gt;<span style="color: Gray">&lt;!--</span> <span style="color: brown"><b>0..1</b></span> <span style="color: navy">Document creation time</span><span style="color: Gray"> --&gt;</span>
 &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.indexed" title="When the document reference was created."><b>indexed</b></a> value=&quot;[<span style="color: darkgreen"><a href="datatypes.html#instant">instant</a></span>]&quot;/&gt;<span style="color: Gray">&lt;!--</span> <span style="color: brown"><b>1..1</b></span> <span style="color: navy">When this document reference created</span><span style="color: Gray"> --&gt;</span>
 &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.status" title="The status of this document reference (this element modifies the meaning of other elements)"><span style="text-decoration: underline"><b>status</b></span></a> value=&quot;[<span style="color: darkgreen"><a href="datatypes.html#code">code</a></span>]&quot;/&gt;<span style="color: Gray">&lt;!--</span> <span style="color: brown"><b>1..1</b></span> <span style="color: navy"><a href="document-reference-status.html" style="color: navy">current | superceded | entered in error</a></span><span style="color: Gray"> --&gt;</span>
 &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.docStatus" title="The status of the underlying document."><b>docStatus</b></a>&gt;<span style="color: Gray">&lt;!--</span> <span style="color: brown"><b>0..1</b></span> <span style="color: darkgreen"><a href="datatypes.html#CodeableConcept">CodeableConcept</a></span> <a href="composition-status.html" style="color: navy">preliminary | final | appended | amended | entered in error</a><span style="color: Gray"> --&gt;</span>&lt;/docStatus&gt;
 &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.relatesTo" title="Relationships that this document has with other document references that already exist
         (this element modifies the meaning of other elements)"><span style="text-decoration: underline"><b>relatesTo</b></span></a>&gt;  <span style="color: Gray">&lt;!-- <span style="color: brown"><b>0..*</b></span> Relationships to other documents --&gt;</span>
  &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.relatesTo.code" title="The type of relationship that this document has with anther document."><b>code</b></a> value=&quot;[<span style="color: darkgreen"><a href="datatypes.html#code">code</a></span>]&quot;/&gt;<span style="color: Gray">&lt;!--</span> <span style="color: brown"><b>1..1</b></span> <span style="color: navy"><a href="document-relationship-type.html" style="color: navy">replaces | transforms | signs | appends</a></span><span style="color: Gray"> --&gt;</span>
  &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.relatesTo.target" title="The target document of this relationship."><b>target</b></a>&gt;<span style="color: Gray">&lt;!--</span> <span style="color: brown"><b>1..1</b></span> <span style="color: darkgreen"><a href="references.html#Resource">Resource</a>(<a href="documentreference.html#DocumentReference">DocumentReference</a>)</span> <span style="color: navy">Target of the relationship</span><span style="color: Gray"> --&gt;</span>&lt;/target&gt;
 &lt;/relatesTo&gt;
 &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.description" title="Human-readable description of the source document. This is sometimes known as the &quot;title&quot;."><b>description</b></a> value=&quot;[<span style="color: darkgreen"><a href="datatypes.html#string">string</a></span>]&quot;/&gt;<span style="color: Gray">&lt;!--</span> <span style="color: brown"><b>0..1</b></span> <span style="color: navy">Human-readable description (title)</span><span style="color: Gray"> --&gt;</span>
 &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.confidentiality" title="A code specifying the level of confidentiality of the XDS Document (this element modifies
         the meaning of other elements)"><span style="text-decoration: underline"><b>confidentiality</b></span></a>&gt;<span style="color: Gray">&lt;!--</span> <span style="color: brown"><b>0..*</b></span> <span style="color: darkgreen"><a href="datatypes.html#CodeableConcept">CodeableConcept</a></span> <a href="v3/vs/Confidentiality/index.html" style="color: navy">Sensitivity of source document</a><span style="color: Gray"> --&gt;</span>&lt;/confidentiality&gt;
 &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.primaryLanguage" title="The primary language in which the source document is written."><b>primaryLanguage</b></a> value=&quot;[<span style="color: darkgreen"><a href="datatypes.html#code">code</a></span>]&quot;/&gt;<span style="color: Gray">&lt;!--</span> <span style="color: brown"><b>0..1</b></span> <span style="color: navy"><a href="http://tools.ietf.org/html/bcp47.html" style="color: navy">The marked primary language for the document</a></span><span style="color: Gray"> --&gt;</span>
 &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.mimeType" title="The mime type of the source document."><b>mimeType</b></a> value=&quot;[<span style="color: darkgreen"><a href="datatypes.html#code">code</a></span>]&quot;/&gt;<span style="color: Gray">&lt;!--</span> <span style="color: brown"><b>1..1</b></span> <span style="color: navy"><a href="http://www.rfc-editor.org/bcp/bcp13.txt.html" style="color: navy">Mime type, + maybe character encoding</a></span><span style="color: Gray"> --&gt;</span>
 &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.format" title="An identifier that identifies that the format and content of the document conforms to
         additional rules beyond the base format indicated in the mimeType."><b>format</b></a> value=&quot;[<span style="color: darkgreen"><a href="datatypes.html#uri">uri</a></span>]&quot;/&gt;<span style="color: Gray">&lt;!--</span> <span style="color: brown"><b>0..*</b></span> <span style="color: navy">Format/content rules for the document</span><span style="color: Gray"> --&gt;</span>
 &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.size" title="The size of the source document this reference refers to in bytes."><b>size</b></a> value=&quot;[<span style="color: darkgreen"><a href="datatypes.html#integer">integer</a></span>]&quot;/&gt;<span style="color: Gray">&lt;!--</span> <span style="color: brown"><b>0..1</b></span> <span style="color: navy">Size of the document in bytes</span><span style="color: Gray"> --&gt;</span>
 &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.hash" title="A hash of the source document to ensure that changes have not occurred."><b>hash</b></a> value=&quot;[<span style="color: darkgreen"><a href="datatypes.html#string">string</a></span>]&quot;/&gt;<span style="color: Gray">&lt;!--</span> <span style="color: brown"><b>0..1</b></span> <span style="color: navy">HexBinary representation of SHA1</span><span style="color: Gray"> --&gt;</span>
 &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.location" title="A url at which the document can be accessed."><b>location</b></a> value=&quot;[<span style="color: darkgreen"><a href="datatypes.html#uri">uri</a></span>]&quot;/&gt;<span style="color: Gray">&lt;!--</span> <span style="color: brown" title="Inv-1: A location or a service (or both) SHALL be provided"><b><img alt="??" src="lock.png"/> 0..1</b></span> <span style="color: navy">Where to access the document</span><span style="color: Gray"> --&gt;</span>
 &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.service" title="A description of a service call that can be used to retrieve the document."><b>service</b></a>&gt;  <span style="color: Gray">&lt;!-- <span style="color: brown" title="Inv-1: A location or a service (or both) SHALL be provided"><b><img alt="??" src="lock.png"/> 0..1</b></span> If access is not fully described by location --&gt;</span>
  &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.service.type" title="The type of the service that can be used to access the documents."><b>type</b></a>&gt;<span style="color: Gray">&lt;!--</span> <span style="color: brown"><b>1..1</b></span> <span style="color: darkgreen"><a href="datatypes.html#CodeableConcept">CodeableConcept</a></span> <span style="color: navy"><a href="valueset-documentreference-service-types.html" style="color: navy">Type of service (i.e. XDS.b)</a></span><span style="color: Gray"> --&gt;</span>&lt;/type&gt;
  &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.service.address" title="Where the service end-point is located."><b>address</b></a> value=&quot;[<span style="color: darkgreen"><a href="datatypes.html#string">string</a></span>]&quot;/&gt;<span style="color: Gray">&lt;!--</span> <span style="color: brown"><b>0..1</b></span> <span style="color: navy">Where service is located (usually a URL)</span><span style="color: Gray"> --&gt;</span>
  &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.service.parameter" title="A list of named parameters that is used in the service call."><b>parameter</b></a>&gt;  <span style="color: Gray">&lt;!-- <span style="color: brown"><b>0..*</b></span> Service call parameters --&gt;</span>
   &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.service.parameter.name" title="The name of a parameter."><b>name</b></a> value=&quot;[<span style="color: darkgreen"><a href="datatypes.html#string">string</a></span>]&quot;/&gt;<span style="color: Gray">&lt;!--</span> <span style="color: brown"><b>1..1</b></span> <span style="color: navy">Parameter name in service call</span><span style="color: Gray"> --&gt;</span>
   &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.service.parameter.value" title="The value of the named parameter."><b>value</b></a> value=&quot;[<span style="color: darkgreen"><a href="datatypes.html#string">string</a></span>]&quot;/&gt;<span style="color: Gray">&lt;!--</span> <span style="color: brown"><b>0..1</b></span> <span style="color: navy">Parameter value for the name</span><span style="color: Gray"> --&gt;</span>
  &lt;/parameter&gt;
 &lt;/service&gt;
 &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.context" title="The clinical context in which the document was prepared."><b>context</b></a>&gt;  <span style="color: Gray">&lt;!-- <span style="color: brown"><b>0..1</b></span> Clinical context of document --&gt;</span>
  &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.context.event" title="This list of codes represents the main clinical acts, such as a colonoscopy or an appendectomy,
         being documented. In some cases, the event is inherent in the typeCode, such as a &quot;History
         and Physical Report&quot; in which the procedure being documented is necessarily a &quot;History
         and Physical&quot; act."><b>event</b></a>&gt;<span style="color: Gray">&lt;!--</span> <span style="color: brown"><b>0..*</b></span> <span style="color: darkgreen"><a href="datatypes.html#CodeableConcept">CodeableConcept</a></span> <a href="v3/ActCode/index.html" style="color: navy">Main Clinical Acts Documented</a><span style="color: Gray"> --&gt;</span>&lt;/event&gt;
  &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.context.period" title="The time period over which the service that is described by the document was provided."><b>period</b></a>&gt;<span style="color: Gray">&lt;!--</span> <span style="color: brown"><b>0..1</b></span> <span style="color: darkgreen"><a href="datatypes.html#Period">Period</a></span> <span style="color: navy">Time of service that is being documented</span><span style="color: Gray"> --&gt;</span>&lt;/period&gt;
  &lt;<a class="dict" href="documentreference-definitions.html#DocumentReference.context.facilityType" title="The kind of facility where the patient was seen."><b>facilityType</b></a>&gt;<span style="color: Gray">&lt;!--</span> <span style="color: brown"><b>0..1</b></span> <span style="color: darkgreen"><a href="datatypes.html#CodeableConcept">CodeableConcept</a></span> <span style="color: navy"><a href="valueset-xds-facilitycodes.html" style="color: navy">Kind of facility where patient was seen</a></span><span style="color: Gray"> --&gt;</span>&lt;/facilityType&gt;
 &lt;/context&gt;
&lt;/DocumentReference&gt;
</pre></div>
  </text>
  <name value="documentreference"/>
  <publisher value="FHIR Project"/>
  <description value="Basic Profile. A reference to a document."/>
  <status value="draft"/>
  <date value="2014-09-30"/>
  <requirements value="Scope and Usage A document reference resource is used to describe a document that is made
   available to a healthcare system. A document is some sequence of bytes that is identifiable,
   establishes its own context (e.g. what subject, author etc), can be displayed to the user,
   and has defined update management. The document resource can be used with any document
   format that has a recognized mime type, and that conforms to this definition.   Typically,
   Document Reference Resources are used in document indexing systems, such as IHE XDS (see
   the XDS specific profile), and are used to refer to:   * CDA documents in FHIR systems
   * FHIR documents stored elsewhere (i.e. registry/repository following the XDS model) *
   PDF documents, and even digital records of faxes where sufficient information is available
   * Other kinds of documents, such as records of prescriptions."/>
  <mapping>
    <identity value="rim"/>
    <uri value="http://hl7.org/v3"/>
    <name value="RIM"/>
  </mapping>
  <mapping>
    <identity value="v2"/>
    <uri value="http://hl7.org/v2"/>
    <name value="HL7 v2"/>
  </mapping>
  <structure>
    <type value="DocumentReference"/>
    <publish value="true"/>
    <element>
      <path value="DocumentReference"/>
      <definition>
        <short value="A reference to a document"/>
        <formal value="A reference to a document."/>
        <comments value="Usually, this is used for documents other than those defined by FHIR."/>
        <min value="1"/>
        <max value="1"/>
        <type>
          <code value="Resource"/>
        </type>
        <constraint>
          <key value="1"/>
          <name value="Location"/>
          <severity value="error"/>
          <human value="A location or a service (or both) SHALL be provided"/>
          <xpath value="exists(f:location) or exists(f:service)"/>
        </constraint>
        <isModifier value="false"/>
        <mapping>
          <identity value="rim"/>
          <map value="Document[classCode=&quot;DOC&quot; and moodCode=&quot;EVN&quot;]"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.extension"/>
      <definition>
        <short value="Additional Content defined by implementations"/>
        <formal 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 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 simplicity
         for everyone."/>
        <synonym value="extensions"/>
        <synonym value="user content"/>
        <min value="0"/>
        <max value="*"/>
        <type>
          <code value="Extension"/>
        </type>
        <isModifier value="false"/>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.modifierExtension"/>
      <definition>
        <short value="Extensions that cannot be ignored"/>
        <formal 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 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 simplicity
         for everyone."/>
        <synonym value="extensions"/>
        <synonym value="user content"/>
        <min value="0"/>
        <max value="*"/>
        <type>
          <code value="Extension"/>
        </type>
        <isModifier value="false"/>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.text"/>
      <definition>
        <short value="Text summary of the resource, for human interpretation"/>
        <formal 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>
        <isModifier value="false"/>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.contained"/>
      <definition>
        <short value="Contained, inline Resources"/>
        <formal 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>
        <isModifier value="false"/>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.masterIdentifier"/>
      <definition>
        <short value="Master Version Specific Identifier"/>
        <formal value="Document identifier as assigned by the source of the document. This identifier is specific
         to this version of the document. This unique identifier may be used elsewhere to identify
         this version of the document."/>
        <min value="1"/>
        <max value="1"/>
        <type>
          <code value="Identifier"/>
        </type>
        <isModifier value="false"/>
        <mapping>
          <identity value="rim"/>
          <map value=".id"/>
        </mapping>
        <mapping>
          <identity value="v2"/>
          <map value="TXA-12-Unique Document Number"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.identifier"/>
      <definition>
        <short value="Other identifiers for the document"/>
        <formal value="Other identifiers associated with the document, including version independent, source
         record and workflow related identifiers."/>
        <comments value="Other identifiers can also include Identifiers may be Accession Numbers, Order Numbers,
         Referral Request  Identifiers, XDS Workflow Instance Identifiers."/>
        <min value="0"/>
        <max value="*"/>
        <type>
          <code value="Identifier"/>
        </type>
        <isModifier value="false"/>
        <mapping>
          <identity value="rim"/>
          <map value=".id / .setId"/>
        </mapping>
        <mapping>
          <identity value="v2"/>
          <map value="TXA-16-Unique Document File Name?"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.subject"/>
      <definition>
        <short value="Who|what is the subject of the document"/>
        <formal value="Who or what the document is about. The document can be about a person, (patient or healthcare
         practitioner), a device (I.e. machine) or even a group of subjects (such as a document
         about a herd of farm animals, or a set of patients that share a common exposure)."/>
        <min value="1"/>
        <max value="1"/>
        <type>
          <code value="ResourceReference"/>
          <profile value="http://hl7.org/fhir/profiles/Patient"/>
        </type>
        <type>
          <code value="ResourceReference"/>
          <profile value="http://hl7.org/fhir/profiles/Practitioner"/>
        </type>
        <type>
          <code value="ResourceReference"/>
          <profile value="http://hl7.org/fhir/profiles/Group"/>
        </type>
        <type>
          <code value="ResourceReference"/>
          <profile value="http://hl7.org/fhir/profiles/Device"/>
        </type>
        <isModifier value="false"/>
        <mapping>
          <identity value="rim"/>
          <map value=".participation[typeCode=&quot;SBJ&quot;].role[typeCode=&quot;PAT&quot;]"/>
        </mapping>
        <mapping>
          <identity value="v2"/>
          <map value="PID-3-Patient ID List (No standard way to define a Practitioner or Group subject in V2
           MDM message)"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.type"/>
      <definition>
        <short value="What kind of document this is (LOINC if possible)"/>
        <formal value="Specifies the particular kind of document (e.g. Patient Summary, Discharge Summary, Prescription,
         etc.)."/>
        <comments value="Key metadata element describing the document, used in searching/filtering."/>
        <min value="1"/>
        <max value="1"/>
        <type>
          <code value="CodeableConcept"/>
        </type>
        <isModifier value="false"/>
        <binding>
          <name value="DocumentType"/>
          <isExtensible value="true"/>
          <conformance value="preferred"/>
          <referenceResource>
            <reference value="http://hl7.org/fhir/vs/doc-codes"/>
          </referenceResource>
        </binding>
        <mapping>
          <identity value="rim"/>
          <map value="./code"/>
        </mapping>
        <mapping>
          <identity value="v2"/>
          <map value="TXA-2-Document Type"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.class"/>
      <definition>
        <short value="Categorization of Document"/>
        <formal value="A categorization for the type of the document. This may be implied by or derived from
         the code specified in the Document Type."/>
        <comments value="Helps humans to assess whether the document is of interest when viewing an index of documents."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="CodeableConcept"/>
        </type>
        <isModifier value="false"/>
        <binding>
          <name value="DocumentClass"/>
          <isExtensible value="true"/>
          <conformance value="example"/>
          <referenceResource>
            <reference value="http://hl7.org/fhir/vs/xds-typecodes"/>
          </referenceResource>
        </binding>
        <mapping>
          <identity value="rim"/>
          <map value=".outboundRelationship[typeCode=&quot;COMP].target[classCode=&quot;LIST&quot;, moodCode=&quot;EVN&quo
          t;].code"/>
        </mapping>
        <mapping>
          <identity value="v2"/>
          <map value=".outboundRelationship[typeCode=&quot;COMP].target[classCode=&quot;LIST&quot;, moodCode=&quot;EVN&quo
          t;].code"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.author"/>
      <definition>
        <short value="Who and/or what authored the document"/>
        <formal value="Identifies who is responsible for adding the information to the document."/>
        <comments value="Not necessarily who did the actual data entry (i.e. typist) it in or who was the source
         (informant)."/>
        <min value="1"/>
        <max value="*"/>
        <type>
          <code value="ResourceReference"/>
          <profile value="http://hl7.org/fhir/profiles/Practitioner"/>
        </type>
        <type>
          <code value="ResourceReference"/>
          <profile value="http://hl7.org/fhir/profiles/Device"/>
        </type>
        <type>
          <code value="ResourceReference"/>
          <profile value="http://hl7.org/fhir/profiles/Patient"/>
        </type>
        <type>
          <code value="ResourceReference"/>
          <profile value="http://hl7.org/fhir/profiles/RelatedPerson"/>
        </type>
        <isModifier value="false"/>
        <mapping>
          <identity value="rim"/>
          <map value=".participation[typeCode=&quot;AUT&quot;].role[classCode=&quot;ASSIGNED&quot;]"/>
        </mapping>
        <mapping>
          <identity value="v2"/>
          <map value="TXA-9-Originator Code/Name (No standard way to indicate a Device in V2 MDM message)"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.custodian"/>
      <definition>
        <short value="Org which maintains the document"/>
        <formal value="Identifies the organization or group who is responsible for ongoing maintenance of and
         access to the document."/>
        <comments value="Identifies the logical organization to go to find the current version, where to report
         issues, etc. This is different from the physical location of the document, which is the
         technical location of the document, which host may be delegated to the management of some
         other organization."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="ResourceReference"/>
          <profile value="http://hl7.org/fhir/profiles/Organization"/>
        </type>
        <isModifier value="false"/>
        <mapping>
          <identity value="rim"/>
          <map value=".participation[typeCode=&quot;RCV&quot;].role[classCode=&quot;CUST&quot;].scoper[classCode=&quot;ORG
          &quot; and determinerCode=&quot;INST&quot;]"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.policyManager"/>
      <definition>
        <short value="Manages access policies for the document"/>
        <formal value="A reference to a domain or server that manages policies under which the document is accessed
         and/or made available."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="uri"/>
        </type>
        <isModifier value="false"/>
        <mapping>
          <identity value="rim"/>
          <map value="N/A - New participation type required"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.authenticator"/>
      <definition>
        <short value="Who/What authenticated the document"/>
        <formal value="Which person or organization authenticates that this document is valid."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="ResourceReference"/>
          <profile value="http://hl7.org/fhir/profiles/Practitioner"/>
        </type>
        <type>
          <code value="ResourceReference"/>
          <profile value="http://hl7.org/fhir/profiles/Organization"/>
        </type>
        <isModifier value="false"/>
        <mapping>
          <identity value="rim"/>
          <map value=".participation[typeCode=&quot;AUTHEN&quot;].role[classCode=&quot;ASSIGNED&quot;]"/>
        </mapping>
        <mapping>
          <identity value="v2"/>
          <map value="TXA-10-Assigned Document Authenticator"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.created"/>
      <definition>
        <short value="Document creation time"/>
        <formal value="When the document was created."/>
        <comments value="Creation time is used for tracking, organizing versions and searching. This is the creation
         time of the document, not the source material on which it is based."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="dateTime"/>
        </type>
        <isModifier value="false"/>
        <mapping>
          <identity value="rim"/>
          <map value=".effectiveTime[type=&quot;TS&quot;]"/>
        </mapping>
        <mapping>
          <identity value="v2"/>
          <map value="TXA-6-Origination Date/Time"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.indexed"/>
      <definition>
        <short value="When this document reference created"/>
        <formal value="When the document reference was created."/>
        <comments value="Referencing/indexing time is used for tracking, organizing versions and searching."/>
        <min value="1"/>
        <max value="1"/>
        <type>
          <code value="instant"/>
        </type>
        <isModifier value="false"/>
        <mapping>
          <identity value="rim"/>
          <map value=".availabilityTime[type=&quot;TS&quot;]"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.status"/>
      <definition>
        <short value="current | superceded | entered in error"/>
        <formal value="The status of this document reference."/>
        <min value="1"/>
        <max value="1"/>
        <type>
          <code value="code"/>
        </type>
        <isModifier value="true"/>
        <binding>
          <name value="DocumentReferenceStatus"/>
          <isExtensible value="false"/>
          <conformance value="required"/>
          <referenceResource>
            <reference value="http://hl7.org/fhir/vs/document-reference-status"/>
          </referenceResource>
        </binding>
        <mapping>
          <identity value="rim"/>
          <map value="interim: .completionCode=&quot;IN&quot; &amp; ./statusCode[isNormalDatatype()]=&quot;active&quot;;
            final: .completionCode=&quot;AU&quot; &amp;&amp;  ./statusCode[isNormalDatatype()]=&quot;complete&q
          uot; and not(./inboundRelationship[typeCode=&quot;SUBJ&quot; and isNormalActRelationship()]/source[su
          bsumesCode(&quot;ActClass#CACT&quot;) and moodCode=&quot;EVN&quot; and domainMember(&quot;ReviseDocum
          ent&quot;, code) and isNormalAct()]);  amended: .completionCode=&quot;AU&quot; &amp;&amp;
            ./statusCode[isNormalDatatype()]=&quot;complete&quot; and ./inboundRelationship[typeCode=&quot;SUBJ
          &quot; and isNormalActRelationship()]/source[subsumesCode(&quot;ActClass#CACT&quot;) and
           moodCode=&quot;EVN&quot; and domainMember(&quot;ReviseDocument&quot;, code) and isNormalAct()
           and statusCode=&quot;completed&quot;];  withdrawn : .completionCode=NI &amp;&amp;  ./statusCode[isNo
          rmalDatatype()]=&quot;obsolete&quot;"/>
        </mapping>
        <mapping>
          <identity value="v2"/>
          <map value="TXA-19-Document Availability Status"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.docStatus"/>
      <definition>
        <short value="preliminary | final | appended | amended | entered in error"/>
        <formal value="The status of the underlying document."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="CodeableConcept"/>
        </type>
        <isModifier value="false"/>
        <binding>
          <name value="ReferredDocumentStatus"/>
          <isExtensible value="true"/>
          <conformance value="preferred"/>
          <referenceResource>
            <reference value="http://hl7.org/fhir/vs/composition-status"/>
          </referenceResource>
        </binding>
        <mapping>
          <identity value="rim"/>
          <map value=".statusCode"/>
        </mapping>
        <mapping>
          <identity value="v2"/>
          <map value="TXA-17-Document Completion Status"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.relatesTo"/>
      <definition>
        <short value="Relationships to other documents"/>
        <formal value="Relationships that this document has with other document references that already exist."/>
        <min value="0"/>
        <max value="*"/>
        <isModifier value="true"/>
        <mapping>
          <identity value="rim"/>
          <map value=".outboundRelationship"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.relatesTo.extension"/>
      <definition>
        <short value="Additional Content defined by implementations"/>
        <formal 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 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 simplicity
         for everyone."/>
        <synonym value="extensions"/>
        <synonym value="user content"/>
        <min value="0"/>
        <max value="*"/>
        <type>
          <code value="Extension"/>
        </type>
        <isModifier value="false"/>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.relatesTo.modifierExtension"/>
      <definition>
        <short value="Extensions that cannot be ignored"/>
        <formal 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 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 simplicity
         for everyone."/>
        <synonym value="extensions"/>
        <synonym value="user content"/>
        <min value="0"/>
        <max value="*"/>
        <type>
          <code value="Extension"/>
        </type>
        <isModifier value="false"/>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.relatesTo.code"/>
      <definition>
        <short value="replaces | transforms | signs | appends"/>
        <formal value="The type of relationship that this document has with anther document."/>
        <comments value="If this document appends another document, then the document cannot be fully understood
         without also accessing the referenced document."/>
        <min value="1"/>
        <max value="1"/>
        <type>
          <code value="code"/>
        </type>
        <isModifier value="false"/>
        <binding>
          <name value="DocumentRelationshipType"/>
          <isExtensible value="false"/>
          <conformance value="required"/>
          <referenceResource>
            <reference value="http://hl7.org/fhir/vs/document-relationship-type"/>
          </referenceResource>
        </binding>
        <mapping>
          <identity value="rim"/>
          <map value=".outboundRelationship.typeCode"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.relatesTo.target"/>
      <definition>
        <short value="Target of the relationship"/>
        <formal value="The target document of this relationship."/>
        <min value="1"/>
        <max value="1"/>
        <type>
          <code value="ResourceReference"/>
          <profile value="http://hl7.org/fhir/profiles/DocumentReference"/>
        </type>
        <isModifier value="false"/>
        <mapping>
          <identity value="rim"/>
          <map value=".target[classCode=&quot;DOC&quot;, moodCode=&quot;EVN&quot;].id"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.description"/>
      <definition>
        <short value="Human-readable description (title)"/>
        <formal value="Human-readable description of the source document. This is sometimes known as the &quot;title&quot;."/>
        <comments value="What the document is about, rather than a terse summary of the document. It is commonly
         the case that records do not have a title and are collectively referred to by the display
         name of Record code (e.g. a &quot;consultation&quot; or &quot;progress note&quot;)."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="string"/>
        </type>
        <isModifier value="false"/>
        <mapping>
          <identity value="rim"/>
          <map value=".outboundRelationship[typeCode=&quot;SUBJ&quot;].target.text"/>
        </mapping>
        <mapping>
          <identity value="v2"/>
          <map value="TXA-25-Document Title"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.confidentiality"/>
      <definition>
        <short value="Sensitivity of source document"/>
        <formal value="A code specifying the level of confidentiality of the XDS Document."/>
        <comments value="The interpretation of this field, and more generally enforcement and issues related to
         highly sensitive documents are beyond the scope of this resource. confidentialityCode
         can only be understood in the context of the policies, procedures, and value set specified
         by the context in which the document reference is being used."/>
        <min value="0"/>
        <max value="*"/>
        <type>
          <code value="CodeableConcept"/>
        </type>
        <isModifier value="true"/>
        <binding>
          <name value="DocumentConfidentiality"/>
          <isExtensible value="true"/>
          <conformance value="preferred"/>
          <referenceResource>
            <reference value="http://hl7.org/fhir/v3/vs/Confidentiality"/>
          </referenceResource>
        </binding>
        <mapping>
          <identity value="rim"/>
          <map value=".confidentialityCode"/>
        </mapping>
        <mapping>
          <identity value="v2"/>
          <map value="TXA-18-Document Confidentiality Status"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.primaryLanguage"/>
      <definition>
        <short value="The marked primary language for the document"/>
        <formal value="The primary language in which the source document is written."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="code"/>
        </type>
        <isModifier value="false"/>
        <binding>
          <name value="Language"/>
          <isExtensible value="false"/>
          <conformance value="required"/>
          <referenceUri value="http://tools.ietf.org/html/bcp47"/>
        </binding>
        <mapping>
          <identity value="rim"/>
          <map value=".languageCode"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.mimeType"/>
      <definition>
        <short value="Mime type, + maybe character encoding"/>
        <formal value="The mime type of the source document."/>
        <comments value="Note: application/hl7-v3+xml for CDA. application/binary for proprietary record formats."/>
        <min value="1"/>
        <max value="1"/>
        <type>
          <code value="code"/>
        </type>
        <isModifier value="false"/>
        <binding>
          <name value="MimeType"/>
          <isExtensible value="false"/>
          <conformance value="required"/>
          <referenceUri value="http://www.rfc-editor.org/bcp/bcp13.txt"/>
        </binding>
        <mapping>
          <identity value="rim"/>
          <map value=".text.mediaType"/>
        </mapping>
        <mapping>
          <identity value="v2"/>
          <map value="TXA-3-Document Content Presentation"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.format"/>
      <definition>
        <short value="Format/content rules for the document"/>
        <formal value="An identifier that identifies that the format and content of the document conforms to
         additional rules beyond the base format indicated in the mimeType."/>
        <comments value="Most often used when the mime-type is text/xml."/>
        <min value="0"/>
        <max value="*"/>
        <type>
          <code value="uri"/>
        </type>
        <isModifier value="false"/>
        <mapping>
          <identity value="rim"/>
          <map value="n/a"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.size"/>
      <definition>
        <short value="Size of the document in bytes"/>
        <formal value="The size of the source document this reference refers to in bytes."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="integer"/>
        </type>
        <isModifier value="false"/>
        <mapping>
          <identity value="rim"/>
          <map value=".text.length"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.hash"/>
      <definition>
        <short value="HexBinary representation of SHA1"/>
        <formal value="A hash of the source document to ensure that changes have not occurred."/>
        <comments value="Whether the hash must be present and/or correct depends on the document handling rules
         defined in the context of use."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="string"/>
        </type>
        <isModifier value="false"/>
        <mapping>
          <identity value="rim"/>
          <map value=".text.integrityCheck"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.location"/>
      <definition>
        <short value="Where to access the document"/>
        <formal value="A url at which the document can be accessed."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="uri"/>
        </type>
        <isModifier value="false"/>
        <mapping>
          <identity value="rim"/>
          <map value=".text.reference"/>
        </mapping>
        <mapping>
          <identity value="v2"/>
          <map value="(Might include V2 TXA-16-Unique Document File Name or TXA-24-Folder Assignment)"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.service"/>
      <definition>
        <short value="If access is not fully described by location"/>
        <formal value="A description of a service call that can be used to retrieve the document."/>
        <comments value="If a document can be accessed by either a service or directly by a URL (i.e. an XDS repository
         with an MHD access point, or a DICOM network with a WADO portal) just provide the URL."/>
        <min value="0"/>
        <max value="1"/>
        <isModifier value="false"/>
        <mapping>
          <identity value="rim"/>
          <map value=".text.reference"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.service.extension"/>
      <definition>
        <short value="Additional Content defined by implementations"/>
        <formal 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 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 simplicity
         for everyone."/>
        <synonym value="extensions"/>
        <synonym value="user content"/>
        <min value="0"/>
        <max value="*"/>
        <type>
          <code value="Extension"/>
        </type>
        <isModifier value="false"/>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.service.modifierExtension"/>
      <definition>
        <short value="Extensions that cannot be ignored"/>
        <formal 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 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 simplicity
         for everyone."/>
        <synonym value="extensions"/>
        <synonym value="user content"/>
        <min value="0"/>
        <max value="*"/>
        <type>
          <code value="Extension"/>
        </type>
        <isModifier value="false"/>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.service.type"/>
      <definition>
        <short value="Type of service (i.e. XDS.b)"/>
        <formal value="The type of the service that can be used to access the documents."/>
        <comments value="The meaning and interpretation of the parameters depends on the service type."/>
        <min value="1"/>
        <max value="1"/>
        <type>
          <code value="CodeableConcept"/>
        </type>
        <isModifier value="false"/>
        <binding>
          <name value="DocumentServiceType"/>
          <isExtensible value="true"/>
          <conformance value="preferred"/>
          <referenceResource>
            <reference value="http://hl7.org/fhir/vs/documentreference-service-types"/>
          </referenceResource>
        </binding>
        <mapping>
          <identity value="rim"/>
          <map value="n/a"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.service.address"/>
      <definition>
        <short value="Where service is located (usually a URL)"/>
        <formal value="Where the service end-point is located."/>
        <comments value="Usually this is a URL, but for some services, the end-point is a simple network name or
         address that is not a valid URL."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="string"/>
        </type>
        <isModifier value="false"/>
        <mapping>
          <identity value="rim"/>
          <map value="n/a"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.service.parameter"/>
      <definition>
        <short value="Service call parameters"/>
        <formal value="A list of named parameters that is used in the service call."/>
        <comments value="The interpretation of the parameters, and how to convert them into a proper service call,
         is dependent on the type of the service, and needs to be specified in an implementation
         guide somewhere."/>
        <min value="0"/>
        <max value="*"/>
        <isModifier value="false"/>
        <mapping>
          <identity value="rim"/>
          <map value="n/a"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.service.parameter.extension"/>
      <definition>
        <short value="Additional Content defined by implementations"/>
        <formal 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 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 simplicity
         for everyone."/>
        <synonym value="extensions"/>
        <synonym value="user content"/>
        <min value="0"/>
        <max value="*"/>
        <type>
          <code value="Extension"/>
        </type>
        <isModifier value="false"/>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.service.parameter.modifierExtension"/>
      <definition>
        <short value="Extensions that cannot be ignored"/>
        <formal 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 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 simplicity
         for everyone."/>
        <synonym value="extensions"/>
        <synonym value="user content"/>
        <min value="0"/>
        <max value="*"/>
        <type>
          <code value="Extension"/>
        </type>
        <isModifier value="false"/>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.service.parameter.name"/>
      <definition>
        <short value="Parameter name in service call"/>
        <formal value="The name of a parameter."/>
        <min value="1"/>
        <max value="1"/>
        <type>
          <code value="string"/>
        </type>
        <isModifier value="false"/>
        <mapping>
          <identity value="rim"/>
          <map value="n/a"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.service.parameter.value"/>
      <definition>
        <short value="Parameter value for the name"/>
        <formal value="The value of the named parameter."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="string"/>
        </type>
        <isModifier value="false"/>
        <mapping>
          <identity value="rim"/>
          <map value="n/a"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.context"/>
      <definition>
        <short value="Clinical context of document"/>
        <formal value="The clinical context in which the document was prepared."/>
        <comments value="These values are primarily added to help with searching for interesting/relevant documents."/>
        <min value="0"/>
        <max value="1"/>
        <isModifier value="false"/>
        <mapping>
          <identity value="rim"/>
          <map value="outboundRelationship[typeCode=&quot;SUBJ&quot;].target[classCode&lt;'ACT']"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.context.extension"/>
      <definition>
        <short value="Additional Content defined by implementations"/>
        <formal 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 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 simplicity
         for everyone."/>
        <synonym value="extensions"/>
        <synonym value="user content"/>
        <min value="0"/>
        <max value="*"/>
        <type>
          <code value="Extension"/>
        </type>
        <isModifier value="false"/>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.context.modifierExtension"/>
      <definition>
        <short value="Extensions that cannot be ignored"/>
        <formal 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 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 simplicity
         for everyone."/>
        <synonym value="extensions"/>
        <synonym value="user content"/>
        <min value="0"/>
        <max value="*"/>
        <type>
          <code value="Extension"/>
        </type>
        <isModifier value="false"/>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.context.event"/>
      <definition>
        <short value="Main Clinical Acts Documented"/>
        <formal value="This list of codes represents the main clinical acts, such as a colonoscopy or an appendectomy,
         being documented. In some cases, the event is inherent in the typeCode, such as a &quot;History
         and Physical Report&quot; in which the procedure being documented is necessarily a &quot;History
         and Physical&quot; act."/>
        <comments value="An event can further specialize the act inherent in the type, such as  where it is simply
         &quot;Procedure Report&quot; and the procedure was a &quot;colonoscopy&quot;. If one or
         more event codes are included, they shall not conflict with the values inherent in the
         class or type elements as such a conflict would create an ambiguous situation."/>
        <min value="0"/>
        <max value="*"/>
        <type>
          <code value="CodeableConcept"/>
        </type>
        <isModifier value="false"/>
        <binding>
          <name value="DocumentEventType"/>
          <isExtensible value="true"/>
          <conformance value="preferred"/>
          <referenceResource>
            <reference value="http://hl7.org/fhir/v3/vs/ActCode"/>
          </referenceResource>
        </binding>
        <mapping>
          <identity value="rim"/>
          <map value=".code"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.context.period"/>
      <definition>
        <short value="Time of service that is being documented"/>
        <formal value="The time period over which the service that is described by the document was provided."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="Period"/>
        </type>
        <isModifier value="false"/>
        <mapping>
          <identity value="rim"/>
          <map value=".effectiveTime"/>
        </mapping>
      </definition>
    </element>
    <element>
      <path value="DocumentReference.context.facilityType"/>
      <definition>
        <short value="Kind of facility where patient was seen"/>
        <formal value="The kind of facility where the patient was seen."/>
        <min value="0"/>
        <max value="1"/>
        <type>
          <code value="CodeableConcept"/>
        </type>
        <isModifier value="false"/>
        <binding>
          <name value="DocumentFacilityType"/>
          <isExtensible value="true"/>
          <conformance value="example"/>
          <referenceResource>
            <reference value="http://hl7.org/fhir/vs/xds-facilitycodes"/>
          </referenceResource>
        </binding>
        <mapping>
          <identity value="rim"/>
          <map value=".participation[typeCode=&quot;LOC&quot;].role[classCode=&quot;DSDLOC&quot;].code"/>
        </mapping>
      </definition>
    </element>
    <searchParam>
      <name value="_id"/>
      <type value="token"/>
      <documentation value="The logical resource id associated with the resource (must be supported by all servers)"/>
    </searchParam>
    <searchParam>
      <name value="_language"/>
      <type value="token"/>
      <documentation value="The language of the resource"/>
    </searchParam>
    <searchParam>
      <name value="authenticator"/>
      <type value="reference"/>
      <documentation value="Who/What authenticated the document"/>
      <xpath value="f:DocumentReference/f:authenticator"/>
    </searchParam>
    <searchParam>
      <name value="author"/>
      <type value="reference"/>
      <documentation value="Who and/or what authored the document"/>
      <xpath value="f:DocumentReference/f:author"/>
    </searchParam>
    <searchParam>
      <name value="class"/>
      <type value="token"/>
      <documentation value="Categorization of Document"/>
      <xpath value="f:DocumentReference/f:class"/>
    </searchParam>
    <searchParam>
      <name value="confidentiality"/>
      <type value="token"/>
      <documentation value="Sensitivity of source document"/>
      <xpath value="f:DocumentReference/f:confidentiality"/>
    </searchParam>
    <searchParam>
      <name value="created"/>
      <type value="date"/>
      <documentation value="Document creation time"/>
      <xpath value="f:DocumentReference/f:created"/>
    </searchParam>
    <searchParam>
      <name value="custodian"/>
      <type value="reference"/>
      <documentation value="Org which maintains the document"/>
      <xpath value="f:DocumentReference/f:custodian"/>
    </searchParam>
    <searchParam>
      <name value="description"/>
      <type value="string"/>
      <documentation value="Human-readable description (title)"/>
      <xpath value="f:DocumentReference/f:description"/>
    </searchParam>
    <searchParam>
      <name value="event"/>
      <type value="token"/>
      <documentation value="Main Clinical Acts Documented"/>
      <xpath value="f:DocumentReference/f:context/f:event"/>
    </searchParam>
    <searchParam>
      <name value="facility"/>
      <type value="token"/>
      <documentation value="Kind of facility where patient was seen"/>
      <xpath value="f:DocumentReference/f:context/f:facilityType"/>
    </searchParam>
    <searchParam>
      <name value="format"/>
      <type value="token"/>
      <documentation value="Format/content rules for the document"/>
      <xpath value="f:DocumentReference/f:format"/>
    </searchParam>
    <searchParam>
      <name value="identifier"/>
      <type value="token"/>
      <documentation value="Master Version Specific Identifier"/>
    </searchParam>
    <searchParam>
      <name value="indexed"/>
      <type value="date"/>
      <documentation value="When this document reference created"/>
      <xpath value="f:DocumentReference/f:indexed"/>
    </searchParam>
    <searchParam>
      <name value="language"/>
      <type value="token"/>
      <documentation value="The marked primary language for the document"/>
      <xpath value="f:DocumentReference/f:primaryLanguage"/>
    </searchParam>
    <searchParam>
      <name value="location"/>
      <type value="string"/>
      <documentation value="Where to access the document"/>
      <xpath value="f:DocumentReference/f:location"/>
    </searchParam>
    <searchParam>
      <name value="period"/>
      <type value="date"/>
      <documentation value="Time of service that is being documented"/>
      <xpath value="f:DocumentReference/f:context/f:period"/>
    </searchParam>
    <searchParam>
      <name value="relatesto"/>
      <type value="reference"/>
      <documentation value="Target of the relationship"/>
      <xpath value="f:DocumentReference/f:relatesTo/f:target"/>
    </searchParam>
    <searchParam>
      <name value="relation"/>
      <type value="token"/>
      <documentation value="replaces | transforms | signs | appends"/>
      <xpath value="f:DocumentReference/f:relatesTo/f:code"/>
    </searchParam>
    <searchParam>
      <name value="relationship"/>
      <type value="composite"/>
      <documentation value="Combination of relation and relatesTo"/>
    </searchParam>
    <searchParam>
      <name value="size"/>
      <type value="number"/>
      <documentation value="Size of the document in bytes"/>
      <xpath value="f:DocumentReference/f:size"/>
    </searchParam>
    <searchParam>
      <name value="status"/>
      <type value="token"/>
      <documentation value="current | superceded | entered in error"/>
      <xpath value="f:DocumentReference/f:status"/>
    </searchParam>
    <searchParam>
      <name value="subject"/>
      <type value="reference"/>
      <documentation value="Who|what is the subject of the document"/>
      <xpath value="f:DocumentReference/f:subject"/>
    </searchParam>
    <searchParam>
      <name value="type"/>
      <type value="token"/>
      <documentation value="What kind of document this is (LOINC if possible)"/>
      <xpath value="f:DocumentReference/f:type"/>
    </searchParam>
  </structure>
</Profile>