Introduction

This US Pathology Composition profile defines how to structure pathology reports based on CAP electronic Cancer Checklists (eCCs) within FHIR.

Key Elements and Binding Requirements

• extension:diagnosticReportReference:
  • DiagnosticReport is bound to both the Observations AND the Composition through this extension
• type:
  • Bound to the CAP eCC Form Codes ValueSet
  • Allows unique identification of the specific CAP Protocol
• section.code:

• Bound to the CAP eCC Section Codes ValueSet

• section.entry:
  • Each entry references a section in the report

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	Composition	A set of resources composed into a single coherent clinical statement with clinical attestation dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
text		0..1	Narrative	Narrative text ele-1: All FHIR elements must have a @value or children
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:diagnosticReport-reference		0..1	(Complex)	Extension URL: http://hl7.org/fhir/us/cancer-reporting/StructureDefinition/composition-diagnosticReportReference ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/us/cancer-reporting/StructureDefinition/composition-diagnosticReportReference"
value[x]		1..1	Reference(US Pathology Diagnostic Report)	Value of extension ele-1: All FHIR elements must have a @value or children
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
identifier	Σ	0..1	Identifier	Report identifier ele-1: All FHIR elements must have a @value or children
status	?!Σ	1..1	code	Status of the Report Binding: CompositionStatus (required): The workflow/clinical status of the composition. ele-1: All FHIR elements must have a @value or children
type	Σ	1..1	CodeableConcept	CAP Form Identifier Binding: CAP eCC Form Codes (extensible) ele-1: All FHIR elements must have a @value or children
subject	Σ	1..1	Reference(US Core Patient Profile)	Who and/or what the composition is about ele-1: All FHIR elements must have a @value or children
encounter	Σ	0..1	Reference(US Core Encounter Profile)	The healthcare event which this Report is about (when test ordered). ele-1: All FHIR elements must have a @value or children
date	Σ	1..1	dateTime	Composition editing time ele-1: All FHIR elements must have a @value or children
author	Σ	1..*	Reference(US Pathology Related Practitioner Role)	Who and/or what authored the Report ele-1: All FHIR elements must have a @value or children
title	Σ	1..1	string	CAP Form Title ele-1: All FHIR elements must have a @value or children
attester		0..*	BackboneElement	Attests the report accuracy ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
mode		1..1	code	personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. ele-1: All FHIR elements must have a @value or children
section	SC	1..*	BackboneElement	Composition is broken into sections cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
title		0..1	string	Title should be the display of the section code ele-1: All FHIR elements must have a @value or children
code		0..1	CodeableConcept	CAP Form Section Identifier Binding: CAP eCC Section Codes (extensible) ele-1: All FHIR elements must have a @value or children
entry	C	1..*	Reference(US Pathology Observation)	An Observation representing this section in the report and containing (hasMember) Observations representing the question/answers in the section. ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Composition.status	required	CompositionStatus http://hl7.org/fhir/ValueSet/composition-status|4.0.1 from the FHIR Standard
Composition.type	extensible	CAPeCCFormCodes http://hl7.org/fhir/us/cancer-reporting/ValueSet/cap-ecc-form-codes from this IG
Composition.attester.mode	required	CompositionAttestationMode http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1 from the FHIR Standard
Composition.section.code	extensible	CAPeCCSectionCodes http://hl7.org/fhir/us/cancer-reporting/ValueSet/cap-ecc-section-codes from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
cmp-1	error	Composition.section	A section must contain at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists()
cmp-2	error	Composition.section	A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty()
dom-2	error	Composition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Composition	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Composition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Composition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Composition	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from Composition

Name	Flags	Card.	Type	Description & Constraints
Composition			Composition
text		0..1	Narrative	Narrative text
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:diagnosticReport-reference		0..1	(Complex)	Extension URL: http://hl7.org/fhir/us/cancer-reporting/StructureDefinition/composition-diagnosticReportReference
value[x]		1..1	Reference(US Pathology Diagnostic Report)	Value of extension
reference		1..1	string	Literal reference, Relative, internal or absolute URL
identifier		0..1	Identifier	Report identifier
status		1..1	code	Status of the Report
type		1..1	CodeableConcept	CAP Form Identifier Binding: CAP eCC Form Codes (extensible)
subject		1..1	Reference(US Core Patient Profile)	Who and/or what the composition is about
encounter		0..1	Reference(US Core Encounter Profile)	The healthcare event which this Report is about (when test ordered).
author		1..*	Reference(US Pathology Related Practitioner Role)	Who and/or what authored the Report
title		1..1	string	CAP Form Title
attester		0..*	BackboneElement	Attests the report accuracy
event
code		0..*	CodeableConcept	Code(s) that apply to the event being documented Binding: ActCode (3.0.0) (required)
section	S	1..*	BackboneElement	Composition is broken into sections
title		0..1	string	Title should be the display of the section code
code		0..1	CodeableConcept	CAP Form Section Identifier Binding: CAP eCC Section Codes (extensible)
entry		1..*	Reference(US Pathology Observation)	An Observation representing this section in the report and containing (hasMember) Observations representing the question/answers in the section.
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Composition.type	extensible	CAPeCCFormCodes http://hl7.org/fhir/us/cancer-reporting/ValueSet/cap-ecc-form-codes from this IG
Composition.event.code	required	ActCode http://terminology.hl7.org/ValueSet/v3-ActCode|3.0.0
Composition.section.code	extensible	CAPeCCSectionCodes http://hl7.org/fhir/us/cancer-reporting/ValueSet/cap-ecc-section-codes from this IG

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	Composition	A set of resources composed into a single coherent clinical statement with clinical attestation
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Narrative text
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:diagnosticReport-reference		0..1	(Complex)	Extension URL: http://hl7.org/fhir/us/cancer-reporting/StructureDefinition/composition-diagnosticReportReference
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/us/cancer-reporting/StructureDefinition/composition-diagnosticReportReference"
value[x]		1..1	Reference(US Pathology Diagnostic Report)	Value of extension
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..1	Identifier	Report identifier
status	?!Σ	1..1	code	Status of the Report Binding: CompositionStatus (required): The workflow/clinical status of the composition.
type	Σ	1..1	CodeableConcept	CAP Form Identifier Binding: CAP eCC Form Codes (extensible)
category	Σ	0..*	CodeableConcept	Categorization of Composition Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
subject	Σ	1..1	Reference(US Core Patient Profile)	Who and/or what the composition is about
encounter	Σ	0..1	Reference(US Core Encounter Profile)	The healthcare event which this Report is about (when test ordered).
date	Σ	1..1	dateTime	Composition editing time
author	Σ	1..*	Reference(US Pathology Related Practitioner Role)	Who and/or what authored the Report
title	Σ	1..1	string	CAP Form Title
confidentiality	Σ	0..1	code	As defined by affinity domain Binding: v3.ConfidentialityClassification (2014-03-26) (required): Codes specifying the level of confidentiality of the composition.
attester		0..*	BackboneElement	Attests the report accuracy
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode		1..1	code	personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition.
time		0..1	dateTime	When the composition was attested
party		0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization)	Who attested the composition
custodian	Σ	0..1	Reference(Organization)	Organization which maintains the composition
relatesTo		0..*	BackboneElement	Relationships to other compositions/documents
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	code	replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target[x]		1..1		Target of the relationship
targetIdentifier			Identifier
targetReference			Reference(Composition)
event	Σ	0..*	BackboneElement	The clinical service(s) being documented
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	0..*	CodeableConcept	Code(s) that apply to the event being documented Binding: ActCode (3.0.0) (required)
period	Σ	0..1	Period	The period covered by the documentation
detail	Σ	0..*	Reference(Resource)	The event(s) being documented
section	SC	1..*	BackboneElement	Composition is broken into sections cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title		0..1	string	Title should be the display of the section code
code		0..1	CodeableConcept	CAP Form Section Identifier Binding: CAP eCC Section Codes (extensible)
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	1..*	Reference(US Pathology Observation)	An Observation representing this section in the report and containing (hasMember) Observations representing the question/answers in the section.
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Composition.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Composition.extension:diagnosticReport-reference.value[x].type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Composition.status	required	CompositionStatus http://hl7.org/fhir/ValueSet/composition-status|4.0.1 from the FHIR Standard
Composition.type	extensible	CAPeCCFormCodes http://hl7.org/fhir/us/cancer-reporting/ValueSet/cap-ecc-form-codes from this IG
Composition.category	example	DocumentClassValueSet http://hl7.org/fhir/ValueSet/document-classcodes from the FHIR Standard
Composition.confidentiality	required	v3.ConfidentialityClassification http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26 from the FHIR Standard
Composition.attester.mode	required	CompositionAttestationMode http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1 from the FHIR Standard
Composition.relatesTo.code	required	DocumentRelationshipType http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1 from the FHIR Standard
Composition.event.code	required	ActCode http://terminology.hl7.org/ValueSet/v3-ActCode|3.0.0
Composition.section.code	extensible	CAPeCCSectionCodes http://hl7.org/fhir/us/cancer-reporting/ValueSet/cap-ecc-section-codes from this IG
Composition.section.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cmp-1	error	Composition.section	A section must contain at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists()
cmp-2	error	Composition.section	A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty()
dom-2	error	Composition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Composition	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Composition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Composition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Composition	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	Composition	A set of resources composed into a single coherent clinical statement with clinical attestation dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
text		0..1	Narrative	Narrative text ele-1: All FHIR elements must have a @value or children
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:diagnosticReport-reference		0..1	(Complex)	Extension URL: http://hl7.org/fhir/us/cancer-reporting/StructureDefinition/composition-diagnosticReportReference ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/us/cancer-reporting/StructureDefinition/composition-diagnosticReportReference"
value[x]		1..1	Reference(US Pathology Diagnostic Report)	Value of extension ele-1: All FHIR elements must have a @value or children
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL ele-1: All FHIR elements must have a @value or children
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
identifier	Σ	0..1	Identifier	Report identifier ele-1: All FHIR elements must have a @value or children
status	?!Σ	1..1	code	Status of the Report Binding: CompositionStatus (required): The workflow/clinical status of the composition. ele-1: All FHIR elements must have a @value or children
type	Σ	1..1	CodeableConcept	CAP Form Identifier Binding: CAP eCC Form Codes (extensible) ele-1: All FHIR elements must have a @value or children
subject	Σ	1..1	Reference(US Core Patient Profile)	Who and/or what the composition is about ele-1: All FHIR elements must have a @value or children
encounter	Σ	0..1	Reference(US Core Encounter Profile)	The healthcare event which this Report is about (when test ordered). ele-1: All FHIR elements must have a @value or children
date	Σ	1..1	dateTime	Composition editing time ele-1: All FHIR elements must have a @value or children
author	Σ	1..*	Reference(US Pathology Related Practitioner Role)	Who and/or what authored the Report ele-1: All FHIR elements must have a @value or children
title	Σ	1..1	string	CAP Form Title ele-1: All FHIR elements must have a @value or children
attester		0..*	BackboneElement	Attests the report accuracy ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
mode		1..1	code	personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. ele-1: All FHIR elements must have a @value or children
section	SC	1..*	BackboneElement	Composition is broken into sections cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
title		0..1	string	Title should be the display of the section code ele-1: All FHIR elements must have a @value or children
code		0..1	CodeableConcept	CAP Form Section Identifier Binding: CAP eCC Section Codes (extensible) ele-1: All FHIR elements must have a @value or children
entry	C	1..*	Reference(US Pathology Observation)	An Observation representing this section in the report and containing (hasMember) Observations representing the question/answers in the section. ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Composition.status	required	CompositionStatus http://hl7.org/fhir/ValueSet/composition-status|4.0.1 from the FHIR Standard
Composition.type	extensible	CAPeCCFormCodes http://hl7.org/fhir/us/cancer-reporting/ValueSet/cap-ecc-form-codes from this IG
Composition.attester.mode	required	CompositionAttestationMode http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1 from the FHIR Standard
Composition.section.code	extensible	CAPeCCSectionCodes http://hl7.org/fhir/us/cancer-reporting/ValueSet/cap-ecc-section-codes from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
cmp-1	error	Composition.section	A section must contain at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists()
cmp-2	error	Composition.section	A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty()
dom-2	error	Composition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Composition	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Composition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Composition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Composition	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Differential View

This structure is derived from Composition

Name	Flags	Card.	Type	Description & Constraints
Composition			Composition
text		0..1	Narrative	Narrative text
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:diagnosticReport-reference		0..1	(Complex)	Extension URL: http://hl7.org/fhir/us/cancer-reporting/StructureDefinition/composition-diagnosticReportReference
value[x]		1..1	Reference(US Pathology Diagnostic Report)	Value of extension
reference		1..1	string	Literal reference, Relative, internal or absolute URL
identifier		0..1	Identifier	Report identifier
status		1..1	code	Status of the Report
type		1..1	CodeableConcept	CAP Form Identifier Binding: CAP eCC Form Codes (extensible)
subject		1..1	Reference(US Core Patient Profile)	Who and/or what the composition is about
encounter		0..1	Reference(US Core Encounter Profile)	The healthcare event which this Report is about (when test ordered).
author		1..*	Reference(US Pathology Related Practitioner Role)	Who and/or what authored the Report
title		1..1	string	CAP Form Title
attester		0..*	BackboneElement	Attests the report accuracy
event
code		0..*	CodeableConcept	Code(s) that apply to the event being documented Binding: ActCode (3.0.0) (required)
section	S	1..*	BackboneElement	Composition is broken into sections
title		0..1	string	Title should be the display of the section code
code		0..1	CodeableConcept	CAP Form Section Identifier Binding: CAP eCC Section Codes (extensible)
entry		1..*	Reference(US Pathology Observation)	An Observation representing this section in the report and containing (hasMember) Observations representing the question/answers in the section.
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Composition.type	extensible	CAPeCCFormCodes http://hl7.org/fhir/us/cancer-reporting/ValueSet/cap-ecc-form-codes from this IG
Composition.event.code	required	ActCode http://terminology.hl7.org/ValueSet/v3-ActCode|3.0.0
Composition.section.code	extensible	CAPeCCSectionCodes http://hl7.org/fhir/us/cancer-reporting/ValueSet/cap-ecc-section-codes from this IG

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	Composition	A set of resources composed into a single coherent clinical statement with clinical attestation
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Narrative text
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:diagnosticReport-reference		0..1	(Complex)	Extension URL: http://hl7.org/fhir/us/cancer-reporting/StructureDefinition/composition-diagnosticReportReference
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/us/cancer-reporting/StructureDefinition/composition-diagnosticReportReference"
value[x]		1..1	Reference(US Pathology Diagnostic Report)	Value of extension
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..1	Identifier	Report identifier
status	?!Σ	1..1	code	Status of the Report Binding: CompositionStatus (required): The workflow/clinical status of the composition.
type	Σ	1..1	CodeableConcept	CAP Form Identifier Binding: CAP eCC Form Codes (extensible)
category	Σ	0..*	CodeableConcept	Categorization of Composition Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
subject	Σ	1..1	Reference(US Core Patient Profile)	Who and/or what the composition is about
encounter	Σ	0..1	Reference(US Core Encounter Profile)	The healthcare event which this Report is about (when test ordered).
date	Σ	1..1	dateTime	Composition editing time
author	Σ	1..*	Reference(US Pathology Related Practitioner Role)	Who and/or what authored the Report
title	Σ	1..1	string	CAP Form Title
confidentiality	Σ	0..1	code	As defined by affinity domain Binding: v3.ConfidentialityClassification (2014-03-26) (required): Codes specifying the level of confidentiality of the composition.
attester		0..*	BackboneElement	Attests the report accuracy
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode		1..1	code	personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition.
time		0..1	dateTime	When the composition was attested
party		0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization)	Who attested the composition
custodian	Σ	0..1	Reference(Organization)	Organization which maintains the composition
relatesTo		0..*	BackboneElement	Relationships to other compositions/documents
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	code	replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target[x]		1..1		Target of the relationship
targetIdentifier			Identifier
targetReference			Reference(Composition)
event	Σ	0..*	BackboneElement	The clinical service(s) being documented
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	0..*	CodeableConcept	Code(s) that apply to the event being documented Binding: ActCode (3.0.0) (required)
period	Σ	0..1	Period	The period covered by the documentation
detail	Σ	0..*	Reference(Resource)	The event(s) being documented
section	SC	1..*	BackboneElement	Composition is broken into sections cmp-1: A section must contain at least one of text, entries, or sub-sections cmp-2: A section can only have an emptyReason if it is empty
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title		0..1	string	Title should be the display of the section code
code		0..1	CodeableConcept	CAP Form Section Identifier Binding: CAP eCC Section Codes (extensible)
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	1..*	Reference(US Pathology Observation)	An Observation representing this section in the report and containing (hasMember) Observations representing the question/answers in the section.
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Composition.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Composition.extension:diagnosticReport-reference.value[x].type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Composition.status	required	CompositionStatus http://hl7.org/fhir/ValueSet/composition-status|4.0.1 from the FHIR Standard
Composition.type	extensible	CAPeCCFormCodes http://hl7.org/fhir/us/cancer-reporting/ValueSet/cap-ecc-form-codes from this IG
Composition.category	example	DocumentClassValueSet http://hl7.org/fhir/ValueSet/document-classcodes from the FHIR Standard
Composition.confidentiality	required	v3.ConfidentialityClassification http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26 from the FHIR Standard
Composition.attester.mode	required	CompositionAttestationMode http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1 from the FHIR Standard
Composition.relatesTo.code	required	DocumentRelationshipType http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1 from the FHIR Standard
Composition.event.code	required	ActCode http://terminology.hl7.org/ValueSet/v3-ActCode|3.0.0
Composition.section.code	extensible	CAPeCCSectionCodes http://hl7.org/fhir/us/cancer-reporting/ValueSet/cap-ecc-section-codes from this IG
Composition.section.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 from the FHIR Standard
Composition.section.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order from the FHIR Standard
Composition.section.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cmp-1	error	Composition.section	A section must contain at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists()
cmp-2	error	Composition.section	A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty()
dom-2	error	Composition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Composition	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Composition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Composition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Composition	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from Composition

Summary

Mandatory: 3 elements(2 nested mandatory elements)
Must-Support: 1 element

Structures

This structure refers to these other structures:

• US Pathology Diagnostic Report (http://hl7.org/fhir/us/cancer-reporting/StructureDefinition/us-pathology-diagnostic-report)
• US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient)
• US Core Encounter Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter)
• US Pathology Related Practitioner Role (http://hl7.org/fhir/us/cancer-reporting/StructureDefinition/us-pathology-related-practitioner-role)
• US Pathology Observation (http://hl7.org/fhir/us/cancer-reporting/StructureDefinition/us-pathology-observation)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/us/cancer-reporting/StructureDefinition/composition-diagnosticReportReference

Maturity: 2