C-CDA on FHIR
1.2.0 - STU 1 United States of America flag

This page is part of the C-CDA on FHIR Implementation Guide (v1.2.0: STU 1) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Resource Profile: ConsultationNote - Detailed Descriptions

Active as of 2024-03-12

Definitions for the Consultation-Note resource profile.

Guidance on how to interpret the contents of this table can be found here

0. Composition
2. Composition.type
ShortConsultation Note
BindingThe codes SHALL be taken from ConsultDocumentType
(required to http://hl7.org/fhir/us/ccda/ValueSet/2.16.840.1.113883.11.20.9.31)
Must Supporttrue
LabelConsultation Note
4. Composition.encounter
ShortencompassingEncounter
Control1..?
Must Supporttrue
LabelencompassingEncounter
6. Composition.section
SlicingThis element introduces a set of slices on Composition.section. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ code
  • 8. Composition.section:allergies_and_intolerances_section
    Slice Nameallergies_and_intolerances_section
    ShortAllergies and Intolerances Section
    Comments

    Allergies and Intolerances Section

    Control1..1
    Must Supporttrue
    LabelAllergies and Intolerances Section
    10. Composition.section:allergies_and_intolerances_section.title
    Shorttitle
    Control1..?
    Must Supporttrue
    12. Composition.section:allergies_and_intolerances_section.code
    ShortAllergies and adverse reactions
    Control1..?
    Must Supporttrue
    LabelAllergies and adverse reactions
    Pattern Value{
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "48765-2"
      }]
    }
    14. Composition.section:allergies_and_intolerances_section.text
    Shorttext
    Control1..?
    Must Supporttrue
    16. Composition.section:allergies_and_intolerances_section.entry
    Shortentry
    SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
    • profile @ resolve()
    • 18. Composition.section:allergies_and_intolerances_section.entry:allergy_intolerance_entry
      Slice Nameallergy_intolerance_entry
      TypeReference(US Core AllergyIntolerance Profile)
      Must Supporttrue
      20. Composition.section:history_of_present_illness_section
      Slice Namehistory_of_present_illness_section
      ShortHistory of Present Illness Section
      Comments

      History of Present Illness Section

      Control1..1
      Must Supporttrue
      LabelHistory of Present Illness Section
      22. Composition.section:history_of_present_illness_section.title
      Shorttitle
      Control1..?
      Must Supporttrue
      24. Composition.section:history_of_present_illness_section.code
      ShortHistory of present illness
      Control1..?
      Must Supporttrue
      LabelHistory of present illness
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "10164-2"
        }]
      }
      26. Composition.section:history_of_present_illness_section.text
      ShortThis section contains only human readable content
      Control1..?
      Must Supporttrue
      28. Composition.section:problem_section
      Slice Nameproblem_section
      ShortProblem Section
      Comments

      Problem Section

      Control1..1
      LabelProblem Section
      30. Composition.section:problem_section.title
      Shorttitle
      Control1..?
      Must Supporttrue
      32. Composition.section:problem_section.code
      ShortProblem list
      Control1..?
      Must Supporttrue
      LabelProblem list
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "11450-4"
        }]
      }
      34. Composition.section:problem_section.text
      Shorttext
      Control1..?
      TypeNarrative
      36. Composition.section:problem_section.entry
      Shortentry
      SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
      • profile @ resolve()
      • 38. Composition.section:problem_section.entry:problem_section_entry
        Slice Nameproblem_section_entry
        TypeReference(US Core Condition Profile)
        Must Supporttrue
        40. Composition.section:medications_section
        Slice Namemedications_section
        ShortMedications Section
        Comments

        Medications Section

        Control0..1
        LabelMedications Section
        42. Composition.section:medications_section.title
        Shorttitle
        Control1..?
        44. Composition.section:medications_section.code
        ShortHistory of medication use
        Control1..?
        LabelHistory of medication use
        Pattern Value{
          "coding" : [{
            "system" : "http://loinc.org",
            "code" : "10160-0"
          }]
        }
        46. Composition.section:medications_section.text
        Shorttext
        Control1..?
        48. Composition.section:medications_section.entry
        Shortentry
        SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
        • profile @ resolve()
        • 50. Composition.section:medications_section.entry:sliceEntry
          Slice NamesliceEntry
          TypeReference(MedicationStatement, US Core Medication Profile, US Core MedicationRequest Profile)
          52. Composition.section:physical_exam_section
          Slice Namephysical_exam_section
          ShortPhysical Exam Section
          Comments

          Physical Exam Section

          Control0..1
          LabelPhysical Exam Section
          54. Composition.section:physical_exam_section.title
          Shorttitle
          Control1..?
          56. Composition.section:physical_exam_section.code
          ShortPhysical findings
          Control1..?
          LabelPhysical findings
          Pattern Value{
            "coding" : [{
              "system" : "http://loinc.org",
              "code" : "29545-1"
            }]
          }
          58. Composition.section:physical_exam_section.text
          Shorttext
          Control1..?
          60. Composition.section:physical_exam_section.entry
          Shortentry
          SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
          • profile @ resolve()
          • 62. Composition.section:physical_exam_section.entry:sliceEntry
            Slice NamesliceEntry
            ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
            TypeReference(Observation)
            64. Composition.section:results_section
            Slice Nameresults_section
            ShortResults Section
            Comments

            Results Section

            Control0..1
            LabelResults Section
            66. Composition.section:results_section.title
            Shorttitle
            Control1..?
            68. Composition.section:results_section.code
            ShortRelevant diagnostic tests/laboratory data
            Control1..?
            LabelRelevant diagnostic tests/laboratory data
            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "30954-2"
              }]
            }
            70. Composition.section:results_section.text
            Shorttext
            Control1..?
            72. Composition.section:results_section.entry
            Shortentry
            SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
            • profile @ resolve()
            • 74. Composition.section:results_section.entry:sliceEntry
              Slice NamesliceEntry
              TypeReference(US Core Laboratory Result Observation Profile)
              76. Composition.section:advance_directives_section
              Slice Nameadvance_directives_section
              ShortAdvance Directives Section
              Comments

              Advance Directives Section

              Control0..1
              Must Supporttrue
              LabelAdvance Directives Section
              78. Composition.section:advance_directives_section.title
              Shorttitle
              Control1..?
              Must Supporttrue
              80. Composition.section:advance_directives_section.code
              ShortAdvance directives
              Control1..?
              Must Supporttrue
              LabelAdvance directives
              Pattern Value{
                "coding" : [{
                  "system" : "http://loinc.org",
                  "code" : "42348-3"
                }]
              }
              82. Composition.section:advance_directives_section.text
              Shorttext
              Control1..?
              Must Supporttrue
              84. Composition.section:advance_directives_section.entry
              SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
              • profile @ resolve()
              • 86. Composition.section:advance_directives_section.entry:advance_directive_entry
                Slice Nameadvance_directive_entry
                TypeReference(Consent)
                Must Supporttrue
                88. Composition.section:assessment_and_plan_section
                Slice Nameassessment_and_plan_section
                ShortAssessment and Plan Section. This section represents the clinician’s conclusions and working assumptions that will guide treatment of the patient. The Assessment and Plan Section may be combined or separated to meet local policy requirements.
                Comments

                Assessment and Plan Section

                Control0..1
                LabelAssessment and Plan Section
                90. Composition.section:assessment_and_plan_section.title
                Shorttitle
                Control1..?
                92. Composition.section:assessment_and_plan_section.code
                ShortAssessment (evaluation) and plan
                Control1..?
                LabelAssessment (evaluation) and plan
                Pattern Value{
                  "coding" : [{
                    "system" : "http://loinc.org",
                    "code" : "51847-2"
                  }]
                }
                94. Composition.section:assessment_and_plan_section.text
                Shorttext
                Control1..?
                96. Composition.section:assessment_and_plan_section.entry
                SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                • profile @ resolve()
                • 98. Composition.section:assessment_and_plan_section.entry:sliceEntry
                  Slice NamesliceEntry
                  ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                  TypeReference(US Core Condition Profile, Observation, Communication)
                  100. Composition.section:assessment_section
                  Slice Nameassessment_section
                  ShortAssessment Section
                  Comments

                  Assessment Section

                  Control0..1
                  LabelAssessment Section
                  102. Composition.section:assessment_section.title
                  Shorttitle
                  Control1..?
                  104. Composition.section:assessment_section.code
                  ShortAssessments (evaluation)
                  Control1..?
                  LabelAssessments (evaluation)
                  Pattern Value{
                    "coding" : [{
                      "system" : "http://loinc.org",
                      "code" : "51848-0"
                    }]
                  }
                  106. Composition.section:assessment_section.text
                  ShortThis section contains only human readable content
                  Control1..?
                  108. Composition.section:chief_complaint_and_reason_for_visit_section
                  Slice Namechief_complaint_and_reason_for_visit_section
                  ShortChief Complaint and Reason for Visit Section. This section records the patient's chief complaint (the patient’s own description) and/or the reason for the patient's visit (the provider’s description of the reason for visit). Local policy determines whether the information is divided into two sections or recorded in one section serving both purposes.
                  Comments

                  Chief Complaint and Reason for Visit Section

                  Control0..1
                  LabelChief Complaint and Reason for Visit Section
                  110. Composition.section:chief_complaint_and_reason_for_visit_section.title
                  Shorttitle
                  Control1..?
                  112. Composition.section:chief_complaint_and_reason_for_visit_section.code
                  ShortChief complaint and reason for visit
                  Control1..?
                  LabelChief complaint and reason for visit
                  Pattern Value{
                    "coding" : [{
                      "system" : "http://loinc.org",
                      "code" : "46239-0"
                    }]
                  }
                  114. Composition.section:chief_complaint_and_reason_for_visit_section.text
                  ShortThis section contains only human readable content
                  Control1..?
                  116. Composition.section:chief_complaint_section
                  Slice Namechief_complaint_section
                  ShortChief Complaint Section
                  Comments

                  Chief Complaint Section

                  Control0..1
                  LabelChief Complaint Section
                  118. Composition.section:chief_complaint_section.title
                  Shorttitle
                  Control1..?
                  120. Composition.section:chief_complaint_section.code
                  ShortChief complaint
                  Control1..?
                  LabelChief complaint
                  Pattern Value{
                    "coding" : [{
                      "system" : "http://loinc.org",
                      "code" : "10154-3"
                    }]
                  }
                  122. Composition.section:chief_complaint_section.text
                  ShortThis section contains only human readable content
                  Control1..?
                  124. Composition.section:family_history_section
                  Slice Namefamily_history_section
                  ShortFamily History Section
                  Comments

                  Family History Section

                  Control0..1
                  LabelFamily History Section
                  126. Composition.section:family_history_section.title
                  Shorttitle
                  Control1..?
                  128. Composition.section:family_history_section.code
                  ShortFamily history
                  Control1..?
                  LabelFamily history
                  Pattern Value{
                    "coding" : [{
                      "system" : "http://loinc.org",
                      "code" : "10157-6"
                    }]
                  }
                  130. Composition.section:family_history_section.text
                  Shorttext
                  Control1..?
                  132. Composition.section:family_history_section.entry
                  Shortentry
                  SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                  • profile @ resolve()
                  • 134. Composition.section:family_history_section.entry:sliceEntry
                    Slice NamesliceEntry
                    ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                    TypeReference(FamilyMemberHistory)
                    136. Composition.section:functional_status_section
                    Slice Namefunctional_status_section
                    ShortFunctional Status Section
                    Comments

                    Functional Status Section

                    Control0..1
                    LabelFunctional Status Section
                    138. Composition.section:functional_status_section.title
                    Shorttitle
                    Control1..?
                    140. Composition.section:functional_status_section.code
                    ShortFunctional status
                    Control1..?
                    LabelFunctional status
                    Pattern Value{
                      "coding" : [{
                        "system" : "http://loinc.org",
                        "code" : "47420-5"
                      }]
                    }
                    142. Composition.section:functional_status_section.text
                    Shorttext
                    Control1..?
                    144. Composition.section:functional_status_section.entry
                    Shortentry
                    SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                    • profile @ resolve()
                    • 146. Composition.section:functional_status_section.entry:sliceEntry
                      Slice NamesliceEntry
                      ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                      TypeReference(Observation)
                      148. Composition.section:general_status_section
                      Slice Namegeneral_status_section
                      ShortGeneral Status Section
                      Comments

                      General Status Section

                      Control0..1
                      LabelGeneral Status Section
                      150. Composition.section:general_status_section.title
                      Shorttitle
                      Control1..?
                      152. Composition.section:general_status_section.code
                      ShortPhysical findings of General status
                      Control1..?
                      LabelPhysical findings of General status
                      Pattern Value{
                        "coding" : [{
                          "system" : "http://loinc.org",
                          "code" : "10210-3"
                        }]
                      }
                      154. Composition.section:general_status_section.text
                      ShortThis section contains only human readable content
                      Control1..?
                      156. Composition.section:past_medical_history_section
                      Slice Namepast_medical_history_section
                      ShortPast Medical History Section
                      Comments

                      Past Medical History Section

                      Control0..1
                      LabelPast Medical History Section
                      158. Composition.section:past_medical_history_section.title
                      Shorttitle
                      Control1..?
                      160. Composition.section:past_medical_history_section.code
                      ShortPast Medical History
                      Control1..?
                      LabelPast Medical History
                      Pattern Value{
                        "coding" : [{
                          "system" : "http://loinc.org",
                          "code" : "11348-0"
                        }]
                      }
                      162. Composition.section:past_medical_history_section.text
                      Shorttext
                      Control1..?
                      164. Composition.section:past_medical_history_section.entry
                      Shortentry
                      SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                      • profile @ resolve()
                      • 166. Composition.section:past_medical_history_section.entry:sliceEntry
                        Slice NamesliceEntry
                        TypeReference(US Core Condition Profile)
                        168. Composition.section:immunizations_section
                        Slice Nameimmunizations_section
                        ShortImmunizations Section
                        Comments

                        Immunizations Section

                        Control0..1
                        LabelImmunizations Section
                        170. Composition.section:immunizations_section.title
                        Shorttitle
                        Control1..?
                        172. Composition.section:immunizations_section.code
                        ShortHistory of immunization
                        Control1..?
                        LabelHistory of immunization
                        Pattern Value{
                          "coding" : [{
                            "system" : "http://loinc.org",
                            "code" : "11369-6"
                          }]
                        }
                        174. Composition.section:immunizations_section.text
                        Shorttext
                        Control1..?
                        176. Composition.section:immunizations_section.entry
                        Shortentry
                        SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                        • profile @ resolve()
                        • 178. Composition.section:immunizations_section.entry:sliceEntry
                          Slice NamesliceEntry
                          TypeReference(US Core Immunization Profile)
                          180. Composition.section:medical_equipment_section
                          Slice Namemedical_equipment_section
                          ShortMedical Equipment Section
                          Comments

                          Medical Equipment Section

                          Control0..1
                          LabelMedical Equipment Section
                          182. Composition.section:medical_equipment_section.title
                          Shorttitle
                          Control1..?
                          184. Composition.section:medical_equipment_section.code
                          ShortHistory of medical device use
                          Control1..?
                          LabelHistory of medical device use
                          Pattern Value{
                            "coding" : [{
                              "system" : "http://loinc.org",
                              "code" : "46264-8"
                            }]
                          }
                          186. Composition.section:medical_equipment_section.text
                          Shorttext
                          Control1..?
                          188. Composition.section:medical_equipment_section.entry
                          Shortentry
                          SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                          • profile @ resolve()
                          • 190. Composition.section:medical_equipment_section.entry:medical_equipment_entry
                            Slice Namemedical_equipment_entry
                            ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                            TypeReference(Device, US Core Procedure Profile)
                            Must Supporttrue
                            Must Support TypesNo must-support rules about the choice of types/profiles
                            192. Composition.section:mental_status_section
                            Slice Namemental_status_section
                            ShortMental Status Section
                            Comments

                            Mental Status Section

                            Control0..1
                            LabelMental Status Section
                            194. Composition.section:mental_status_section.title
                            Shorttitle
                            Control1..?
                            196. Composition.section:mental_status_section.code
                            ShortMental status
                            Control1..?
                            LabelMental status
                            Pattern Value{
                              "coding" : [{
                                "system" : "http://loinc.org",
                                "code" : "10190-7"
                              }]
                            }
                            198. Composition.section:mental_status_section.text
                            Shorttext
                            Control1..?
                            200. Composition.section:mental_status_section.entry
                            Shortentry
                            SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                            • profile @ resolve()
                            • 202. Composition.section:mental_status_section.entry:sliceEntry
                              Slice NamesliceEntry
                              ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                              TypeReference(Observation)
                              204. Composition.section:nutrition_section
                              Slice Namenutrition_section
                              ShortNutrition Section
                              Comments

                              Nutrition Section

                              Control0..1
                              LabelNutrition Section
                              206. Composition.section:nutrition_section.title
                              Shorttitle
                              Control1..?
                              208. Composition.section:nutrition_section.code
                              ShortDiet and nutrition
                              Control1..?
                              LabelDiet and nutrition
                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://loinc.org",
                                  "code" : "61144-2"
                                }]
                              }
                              210. Composition.section:nutrition_section.text
                              Shorttext
                              Control1..?
                              212. Composition.section:nutrition_section.entry
                              Shortentry
                              SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                              • profile @ resolve()
                              • 214. Composition.section:nutrition_section.entry:sliceEntry
                                Slice NamesliceEntry
                                ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                                TypeReference(NutritionOrder, ClinicalImpression)
                                216. Composition.section:plan_of_treatment_section
                                Slice Nameplan_of_treatment_section
                                ShortPlan of Treatment Section
                                Comments

                                Plan of Treatment Section

                                Control0..1
                                LabelPlan of Treatment Section
                                218. Composition.section:plan_of_treatment_section.title
                                Shorttitle
                                Control1..?
                                220. Composition.section:plan_of_treatment_section.code
                                ShortPlan of treatment
                                Control1..?
                                LabelPlan of treatment
                                Pattern Value{
                                  "coding" : [{
                                    "system" : "http://loinc.org",
                                    "code" : "18776-5"
                                  }]
                                }
                                222. Composition.section:plan_of_treatment_section.text
                                Shorttext
                                Control1..?
                                224. Composition.section:plan_of_treatment_section.entry
                                Shortentry
                                SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                • profile @ resolve()
                                • 226. Composition.section:plan_of_treatment_section.entry:sliceEntry
                                  Slice NamesliceEntry
                                  ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                                  TypeReference(US Core Goal Profile, US Core MedicationRequest Profile, US Core Encounter Profile, Communication, Appointment, CommunicationRequest, DeviceRequest, NutritionOrder, Task, ServiceRequest, VisionPrescription, RequestGroup)
                                  228. Composition.section:procedures_section
                                  Slice Nameprocedures_section
                                  ShortProcedures Section
                                  Comments

                                  Procedures Section

                                  Control0..1
                                  LabelProcedures Section
                                  230. Composition.section:procedures_section.title
                                  Shorttitle
                                  Control1..?
                                  232. Composition.section:procedures_section.code
                                  ShortHistory of Procedures
                                  Control1..?
                                  LabelHistory of Procedures
                                  Pattern Value{
                                    "coding" : [{
                                      "system" : "http://loinc.org",
                                      "code" : "47519-4"
                                    }]
                                  }
                                  234. Composition.section:procedures_section.text
                                  Shorttext
                                  Control1..?
                                  236. Composition.section:procedures_section.entry
                                  Shortentry
                                  SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                  • profile @ resolve()
                                  • 238. Composition.section:procedures_section.entry:sliceEntry
                                    Slice NamesliceEntry
                                    TypeReference(US Core Procedure Profile)
                                    240. Composition.section:reason_for_visit_section
                                    Slice Namereason_for_visit_section
                                    ShortReason for Visit Section
                                    Comments

                                    Reason for Visit Section

                                    Control0..1
                                    LabelReason for Visit Section
                                    242. Composition.section:reason_for_visit_section.title
                                    Shorttitle
                                    Control1..?
                                    244. Composition.section:reason_for_visit_section.code
                                    ShortReason for visit
                                    Control1..?
                                    LabelReason for visit
                                    Pattern Value{
                                      "coding" : [{
                                        "system" : "http://loinc.org",
                                        "code" : "29299-5"
                                      }]
                                    }
                                    246. Composition.section:reason_for_visit_section.text
                                    ShortThis section contains only human readable content
                                    Control1..?
                                    248. Composition.section:review_of_systems_section
                                    Slice Namereview_of_systems_section
                                    ShortReview of Systems Section
                                    Comments

                                    Review of Systems Section

                                    Control0..1
                                    LabelReview of Systems Section
                                    250. Composition.section:review_of_systems_section.title
                                    Shorttitle
                                    Control1..?
                                    252. Composition.section:review_of_systems_section.code
                                    ShortReview of systems
                                    Control1..?
                                    LabelReview of systems
                                    Pattern Value{
                                      "coding" : [{
                                        "system" : "http://loinc.org",
                                        "code" : "10187-3"
                                      }]
                                    }
                                    254. Composition.section:review_of_systems_section.text
                                    ShortThis section contains only human readable content
                                    Control1..?
                                    256. Composition.section:social_history_section
                                    Slice Namesocial_history_section
                                    ShortSocial History Section
                                    Comments

                                    Social History Section

                                    Control0..1
                                    LabelSocial History Section
                                    258. Composition.section:social_history_section.title
                                    Shorttitle
                                    Control1..?
                                    260. Composition.section:social_history_section.code
                                    ShortSocial history
                                    Control1..?
                                    LabelSocial history
                                    Pattern Value{
                                      "coding" : [{
                                        "system" : "http://loinc.org",
                                        "code" : "29762-2"
                                      }]
                                    }
                                    262. Composition.section:social_history_section.text
                                    Shorttext
                                    Control1..?
                                    264. Composition.section:social_history_section.entry
                                    Shortentry
                                    SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                    • profile @ resolve()
                                    • 266. Composition.section:social_history_section.entry:sliceEntry
                                      Slice NamesliceEntry
                                      ShortSmoking status
                                      TypeReference(US Core Smoking Status Observation Profile)
                                      268. Composition.section:vital_signs_section
                                      Slice Namevital_signs_section
                                      ShortVital Signs Section
                                      Comments

                                      Vital Signs Section

                                      Control0..1
                                      LabelVital Signs Section
                                      270. Composition.section:vital_signs_section.title
                                      Shorttitle
                                      Control1..?
                                      272. Composition.section:vital_signs_section.code
                                      ShortVital signs
                                      Control1..?
                                      LabelVital signs
                                      Pattern Value{
                                        "coding" : [{
                                          "system" : "http://loinc.org",
                                          "code" : "8716-3"
                                        }]
                                      }
                                      274. Composition.section:vital_signs_section.text
                                      Shorttext
                                      Control1..?
                                      276. Composition.section:vital_signs_section.entry
                                      Shortentry
                                      SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                      • profile @ resolve()
                                      • 278. Composition.section:vital_signs_section.entry:sliceEntry
                                        Slice NamesliceEntry
                                        TypeReference(Vital Signs Profile)

                                        Guidance on how to interpret the contents of this table can be found here

                                        0. Composition
                                        Definition

                                        A set of healthcare-related information that is assembled together into a single logical package that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. A Composition defines the structure and narrative content necessary for a document. However, a Composition alone does not constitute a document. Rather, the Composition must be the first entry in a Bundle where Bundle.type=document, and any other resources referenced from Composition must be included as subsequent entries in the Bundle (for example Patient, Practitioner, Encounter, etc.).

                                        ShortA set of resources composed into a single coherent clinical statement with clinical attestation
                                        Comments

                                        While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical.

                                        Control0..*
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                                        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 (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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                                        dom-6: A resource should have narrative for robust management (text.`div`.exists())
                                        2. Composition.implicitRules
                                        Definition

                                        A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                                        ShortA set of rules under which this content was created
                                        Comments

                                        Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                                        Control0..1
                                        Typeuri
                                        Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        4. Composition.language
                                        Definition

                                        The base language in which the resource is written.

                                        ShortlanguageLanguage of the resource content
                                        Comments

                                        Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

                                        Control10..1
                                        BindingThe codes SHOULD be taken from CommonLanguageshttp://hl7.org/fhir/ValueSet/languages
                                        (preferred to http://hl7.org/fhir/ValueSet/languages)

                                        A human language.

                                        Additional BindingsPurpose
                                        AllLanguagesMax Binding
                                        Typecode
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supporttrue
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        6. Composition.extension:versionNumber
                                        Slice NameversionNumber
                                        Definition

                                        Version specific identifier for the composition, assigned when each version is created/updated.

                                        ShortVersion-specific identifier for composition
                                        Comments

                                        While each resource, including the composition itself, has its own version identifier, this is a formal identifier for the logical version of the composition as a whole. It would remain constant if the resources were moved to a new server, and all got new individual resource versions, for example.

                                        Control0..*
                                        This element is affected by the following invariants: ele-1
                                        TypeExtension(Composition Version Number) (Extension Type: string)
                                        Is Modifierfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        8. Composition.extension:version_number_extension
                                        Slice Nameversion_number_extension
                                        Definition

                                        An Extension

                                        ShortExtension
                                        Control0..1
                                        TypeExtension(Version Number) (Extension Type: integer)
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        10. Composition.extension:data_enterer_extension
                                        Slice Namedata_enterer_extension
                                        Definition

                                        An Extension

                                        ShortExtension
                                        Control0..1
                                        TypeExtension(Data Enterer Extension) (Extension Type: Reference)
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        12. Composition.extension:informant_extension
                                        Slice Nameinformant_extension
                                        Definition

                                        An Extension

                                        Shortinformant
                                        Control0..*
                                        TypeExtension(Informant Extension) (Extension Type: Reference)
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summaryfalse
                                        Labelinformant
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        14. Composition.extension:information_recipient_extension
                                        Slice Nameinformation_recipient_extension
                                        Definition

                                        An Extension

                                        ShortinformationRecipient
                                        Control0..*
                                        TypeExtension(Information Recipient Extension) (Extension Type: Reference)
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summaryfalse
                                        LabelinformationRecipient
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        16. Composition.extension:participant_extension
                                        Slice Nameparticipant_extension
                                        Definition

                                        An Extension

                                        Shortparticipant
                                        Control0..*
                                        TypeExtension(Participant Extension) (Extension Type: Reference)
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summaryfalse
                                        Labelparticipant
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        18. Composition.extension:performer_extension
                                        Slice Nameperformer_extension
                                        Definition

                                        An Extension

                                        Shortperformer
                                        Control0..*
                                        TypeExtension(Performer Extension) (Extension Type: Reference)
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summaryfalse
                                        Labelperformer
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        20. Composition.extension:authorization_extension
                                        Slice Nameauthorization_extension
                                        Definition

                                        An Extension

                                        Shortauthorization
                                        Control0..*
                                        TypeExtension(Authorization Extension) (Extension Type: Reference)
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summaryfalse
                                        Labelauthorization
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        22. Composition.extension:order_extension
                                        Slice Nameorder_extension
                                        Definition

                                        An Extension

                                        Shortauthorization
                                        Control0..*
                                        TypeExtension(Order Extension) (Extension Type: Reference)
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summaryfalse
                                        Labelauthorization
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        24. Composition.modifierExtension
                                        Definition

                                        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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                        ShortExtensions that cannot be ignored
                                        Comments

                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                        Control0..*
                                        TypeExtension
                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                                        Summaryfalse
                                        Requirements

                                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.


                                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                        Alternate Namesextensions, user content
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        26. Composition.identifier
                                        Definition

                                        A version-independent identifier for the Composition. This identifier stays constant as the composition is changed over time.

                                        ShortidentifierVersion-independent identifier for the Composition
                                        Comments

                                        Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate.

                                        NoteThis is a business identifier, not a resource identifier (see discussion)
                                        Control10..1
                                        TypeIdentifier
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        28. Composition.status
                                        Definition

                                        The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.

                                        Shortpreliminary | final | amended | entered-in-error
                                        Comments

                                        If a composition is marked as withdrawn, the compositions/documents in the series, or data from the composition or document series, should never be displayed to a user without being clearly marked as untrustworthy. The flag "entered-in-error" is why this element is labeled as a modifier of other elements.

                                        Some reporting work flows require that the original narrative of a final document never be altered; instead, only new narrative can be added. The composition resource has no explicit status for explicitly noting whether this business rule is in effect. This would be handled by an extension if required.

                                        Control1..1
                                        BindingThe codes SHALL be taken from CompositionStatushttp://hl7.org/fhir/ValueSet/composition-status|4.0.1
                                        (required to http://hl7.org/fhir/ValueSet/composition-status|4.0.1)

                                        The workflow/clinical status of the composition.

                                        Typecode
                                        Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Requirements

                                        Need to be able to mark interim, amended, or withdrawn compositions or documents.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        30. Composition.type
                                        Definition

                                        Specifies the particular kind of composition (e.g. History and Physical, Discharge Summary, Progress Note). This usually equates to the purpose of making the composition.

                                        ShortConsultation NoteKind of composition (LOINC if possible)
                                        Comments

                                        For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation guides will require a specific LOINC code, or use LOINC as an extensible binding.

                                        Control1..1
                                        BindingThe codes SHALL be taken from The codes SHOULD be taken from ConsultDocumentTypehttp://hl7.org/fhir/ValueSet/doc-typecodes
                                        (required to http://hl7.org/fhir/us/ccda/ValueSet/2.16.840.1.113883.11.20.9.31)
                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summarytrue
                                        Requirements

                                        Key metadata element describing the composition, used in searching/filtering.

                                        LabelConsultation Note
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        32. Composition.subject
                                        Definition

                                        Who or what the composition is about. The composition can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure).

                                        ShortWho and/or what the composition is about
                                        Comments

                                        For clinical documents, this is usually the patient.

                                        Control0..1
                                        TypeReference(US Core Patient Profile, Group, Resource)
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Must Support TypesNo must-support rules about the choice of types/profiles
                                        Summarytrue
                                        Requirements

                                        Essential metadata for searching for the composition. Identifies who and/or what the composition/document is about.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        34. Composition.encounter
                                        Definition

                                        Describes the clinical encounter or type of care this documentation is associated with.

                                        ShortencompassingEncounterContext of the Composition
                                        Control10..1
                                        TypeReference(US Core Encounter Profile, Encounter)
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summarytrue
                                        Requirements

                                        Provides context for the composition and supports searching.

                                        LabelencompassingEncounter
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        36. Composition.date
                                        Definition

                                        The composition editing time, when the composition was last logically changed by the author.

                                        ShortdateComposition editing time
                                        Comments

                                        The Last Modified Date on the composition may be after the date of the document was attested without being changed.

                                        Control1..1
                                        TypedateTime
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supporttrue
                                        Summarytrue
                                        Requirements

                                        dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring. When packaged in a document, Bundle.timestamp is the date of packaging.


                                        dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring. When packaged in a document, Bundle.timestamp is the date of packaging.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        38. Composition.author
                                        Definition

                                        Identifies who is responsible for the information in the composition, not necessarily who typed it in.

                                        ShortWho and/or what authored the composition
                                        Control1..*
                                        TypeReference(US Core Practitioner Profile, US Core PractitionerRole Profile, PractitionerRole, US Core Patient Profile, Device, RelatedPerson, Practitioner, Patient, Organization)
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Must Support TypesNo must-support rules about the choice of types/profiles
                                        Summarytrue
                                        Requirements

                                        Identifies who is responsible for the content.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        40. Composition.title
                                        Definition

                                        Official human-readable label for the composition.

                                        ShortDocument TitleHuman Readable name/title
                                        Comments

                                        For many compositions, the title is the same as the text or a display name of Composition.type (e.g. a "consultation" or "progress note"). Note that CDA does not make title mandatory, but there are no known cases where it is useful for title to be omitted, so it is mandatory here. Feedback on this requirement is welcome during the trial use period.

                                        Control1..1
                                        Typestring
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supporttrue
                                        Summarytrue
                                        LabelDocument Title
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        42. Composition.confidentiality
                                        Definition

                                        Use the confidentiality codes in Meta.security (https://hl7.org/fhir/security-labels.html)


                                        The code specifying the level of confidentiality of the Composition.

                                        ShortUse the confidentiality codes in Meta.securityAs defined by affinity domain
                                        Comments

                                        The exact use of this element, and enforcement and issues related to highly sensitive documents are out of scope for the base specification, and delegated to implementation profiles (see security section). This element is labeled as a modifier because highly confidential documents must not be treated as if they are not.

                                        Control0..01
                                        BindingThe codes SHALL be taken from v3.ConfidentialityClassification (2014-03-26)http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26
                                        (required to http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26)

                                        Codes specifying the level of confidentiality of the composition.

                                        Typecode
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supportfalse
                                        Summarytrue
                                        LabelUse the confidentiality codes in Meta.security
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        44. Composition.attester
                                        Definition

                                        A participant who has attested to the accuracy of the composition/document.

                                        ShortAttests to accuracy of composition
                                        Comments

                                        Only list each attester once.

                                        Control0..*
                                        TypeBackboneElement
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summaryfalse
                                        Requirements

                                        Identifies responsibility for the accuracy of the composition content.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        SlicingThis element introduces a set of slices on Composition.attester. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                        • value @ mode
                                        • 46. Composition.attester.modifierExtension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                          ShortExtensions that cannot be ignored even if unrecognized
                                          Comments

                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                          Control0..*
                                          TypeExtension
                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                          Summarytrue
                                          Requirements

                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.


                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                          Alternate Namesextensions, user content, modifiers
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          48. Composition.attester.mode
                                          Definition

                                          The type of attestation the authenticator offers.

                                          Shortpersonal | professional | legal | official
                                          Control1..1
                                          BindingThe codes SHALL be taken from CompositionAttestationModehttp://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1
                                          (required to http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1)

                                          The way in which a person authenticated a composition.

                                          Typecode
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summaryfalse
                                          Requirements

                                          Indicates the level of authority of the attestation.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          50. Composition.attester:legal_attester
                                          Slice Namelegal_attester
                                          Definition

                                          A participant who has attested to the accuracy of the composition/document.

                                          ShortattesterAttests to accuracy of composition
                                          Comments

                                          Only list each attester once.

                                          Control0..1*
                                          TypeBackboneElement
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Summaryfalse
                                          Requirements

                                          Identifies responsibility for the accuracy of the composition content.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          52. Composition.attester:legal_attester.modifierExtension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                          ShortExtensions that cannot be ignored even if unrecognized
                                          Comments

                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                          Control0..*
                                          TypeExtension
                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                          Summarytrue
                                          Requirements

                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.


                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                          Alternate Namesextensions, user content, modifiers
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          54. Composition.attester:legal_attester.mode
                                          Definition

                                          The type of attestation the authenticator offers.

                                          Shortmodepersonal | professional | legal | official
                                          Control1..1
                                          BindingThe codes SHALL be taken from CompositionAttestationModehttp://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1
                                          (required to http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1)

                                          The way in which a person authenticated a composition.

                                          Typecode
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supporttrue
                                          Summaryfalse
                                          Requirements

                                          Indicates the level of authority of the attestation.

                                          Fixed Valuelegal
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          56. Composition.attester:legal_attester.party
                                          Definition

                                          Who attested the composition in the specified way.

                                          ShortpartyWho attested the composition
                                          Control10..1
                                          TypeReference(US Core Practitioner Profile, US Core PractitionerRole Profile, Patient, RelatedPerson, Practitioner, PractitionerRole, Organization)
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Must Support TypesNo must-support rules about the choice of types/profiles
                                          Summaryfalse
                                          Requirements

                                          Identifies who has taken on the responsibility for accuracy of the composition content.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          58. Composition.attester:professional_attester
                                          Slice Nameprofessional_attester
                                          Definition

                                          A participant who has attested to the accuracy of the composition/document.

                                          ShortattesterAttests to accuracy of composition
                                          Comments

                                          Only list each attester once.

                                          Control0..*
                                          TypeBackboneElement
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Summaryfalse
                                          Requirements

                                          Identifies responsibility for the accuracy of the composition content.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          60. Composition.attester:professional_attester.modifierExtension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                          ShortExtensions that cannot be ignored even if unrecognized
                                          Comments

                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                          Control0..*
                                          TypeExtension
                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                          Summarytrue
                                          Requirements

                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.


                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                          Alternate Namesextensions, user content, modifiers
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          62. Composition.attester:professional_attester.mode
                                          Definition

                                          The type of attestation the authenticator offers.

                                          Shortmodepersonal | professional | legal | official
                                          Control1..1
                                          BindingThe codes SHALL be taken from CompositionAttestationModehttp://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1
                                          (required to http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1)

                                          The way in which a person authenticated a composition.

                                          Typecode
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supporttrue
                                          Summaryfalse
                                          Requirements

                                          Indicates the level of authority of the attestation.

                                          Fixed Valueprofessional
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          64. Composition.attester:professional_attester.party
                                          Definition

                                          Who attested the composition in the specified way.

                                          ShortpartyWho attested the composition
                                          Control10..1
                                          TypeReference(US Core Practitioner Profile, US Core PractitionerRole Profile, Patient, RelatedPerson, Practitioner, PractitionerRole, Organization)
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Must Support TypesNo must-support rules about the choice of types/profiles
                                          Summaryfalse
                                          Requirements

                                          Identifies who has taken on the responsibility for accuracy of the composition content.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          66. Composition.attester:personal_attester
                                          Slice Namepersonal_attester
                                          Definition

                                          A participant who has attested to the accuracy of the composition/document.

                                          ShortattesterAttests to accuracy of composition
                                          Comments

                                          Only list each attester once.

                                          Control0..*
                                          TypeBackboneElement
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Summaryfalse
                                          Requirements

                                          Identifies responsibility for the accuracy of the composition content.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          68. Composition.attester:personal_attester.modifierExtension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                          ShortExtensions that cannot be ignored even if unrecognized
                                          Comments

                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                          Control0..*
                                          TypeExtension
                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                          Summarytrue
                                          Requirements

                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.


                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                          Alternate Namesextensions, user content, modifiers
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          70. Composition.attester:personal_attester.mode
                                          Definition

                                          The type of attestation the authenticator offers.

                                          Shortmodepersonal | professional | legal | official
                                          Control1..1
                                          BindingThe codes SHALL be taken from CompositionAttestationModehttp://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1
                                          (required to http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1)

                                          The way in which a person authenticated a composition.

                                          Typecode
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supporttrue
                                          Summaryfalse
                                          Requirements

                                          Indicates the level of authority of the attestation.

                                          Fixed Valuepersonal
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          72. Composition.attester:personal_attester.party
                                          Definition

                                          Who attested the composition in the specified way.

                                          ShortpartyWho attested the composition
                                          Control10..1
                                          TypeReference(US Core Patient Profile, RelatedPerson, Patient, Practitioner, PractitionerRole, Organization)
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Must Support TypesNo must-support rules about the choice of types/profiles
                                          Summaryfalse
                                          Requirements

                                          Identifies who has taken on the responsibility for accuracy of the composition content.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          74. Composition.custodian
                                          Definition

                                          Identifies the organization or group who is responsible for ongoing maintenance of and access to the composition/document information.

                                          ShortcustodianOrganization which maintains the composition
                                          Comments

                                          This is useful when documents are derived from a composition - provides guidance for how to get the latest version of the document. This is optional because this is sometimes not known by the authoring system, and can be inferred by context. However, it is important that this information be known when working with a derived document, so providing a custodian is encouraged.

                                          Control10..1
                                          TypeReference(US Core Organization Profile, Organization)
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Summarytrue
                                          Requirements

                                          Identifies where to go to find the current version, where to report issues, etc.

                                          Labelcustodian
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          76. Composition.section
                                          Definition

                                          The root of the sections that make up the composition.

                                          ShortComposition is broken into sections
                                          Control0..*
                                          TypeBackboneElement
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                          SlicingThis element introduces a set of slices on Composition.section. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                          • value @ code
                                          • 78. Composition.section.modifierExtension
                                            Definition

                                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                            ShortExtensions that cannot be ignored even if unrecognized
                                            Comments

                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                            Control0..*
                                            TypeExtension
                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                            Summarytrue
                                            Requirements

                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.


                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                            Alternate Namesextensions, user content, modifiers
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            80. Composition.section:allergies_and_intolerances_section
                                            Slice Nameallergies_and_intolerances_section
                                            Definition

                                            The root of the sections that make up the composition.

                                            ShortAllergies and Intolerances SectionComposition is broken into sections
                                            Comments

                                            Allergies and Intolerances Section

                                            Control10..1*
                                            TypeBackboneElement
                                            Is Modifierfalse
                                            Must Supporttrue
                                            Summaryfalse
                                            LabelAllergies and Intolerances Section
                                            Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                            82. Composition.section:allergies_and_intolerances_section.modifierExtension
                                            Definition

                                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                            ShortExtensions that cannot be ignored even if unrecognized
                                            Comments

                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                            Control0..*
                                            TypeExtension
                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                            Summarytrue
                                            Requirements

                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.


                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                            Alternate Namesextensions, user content, modifiers
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            84. Composition.section:allergies_and_intolerances_section.title
                                            Definition

                                            The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                            ShorttitleLabel for section (e.g. for ToC)
                                            Comments

                                            The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                            Control10..1
                                            Typestring
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supporttrue
                                            Summaryfalse
                                            Requirements

                                            Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                            Alternate Namesheader, label, caption
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            86. Composition.section:allergies_and_intolerances_section.code
                                            Definition

                                            A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                            ShortAllergies and adverse reactionsClassification of section (recommended)
                                            Comments

                                            The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                            If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                            Control10..1
                                            BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                            (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                            Classification of a section of a composition/document.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Must Supporttrue
                                            Summaryfalse
                                            Requirements

                                            Provides computable standardized labels to topics within the document.

                                            LabelAllergies and adverse reactions
                                            Pattern Value{
                                              "coding" : [{
                                                "system" : "http://loinc.org",
                                                "code" : "48765-2"
                                              }]
                                            }
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            88. Composition.section:allergies_and_intolerances_section.text
                                            Definition

                                            A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                            ShorttextText summary of the section, for human interpretation
                                            Comments

                                            Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                            Control10..1
                                            This element is affected by the following invariants: cmp-1
                                            TypeNarrative
                                            Is Modifierfalse
                                            Must Supporttrue
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            90. Composition.section:allergies_and_intolerances_section.entry
                                            Definition

                                            A reference to the actual resource from which the narrative in the section is derived.

                                            ShortentryA reference to data that supports this section
                                            Comments

                                            If there are no entries in the list, an emptyReason SHOULD be provided.

                                            Control0..*
                                            This element is affected by the following invariants: cmp-2
                                            TypeReference(Resource)
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                            • profile @ resolve()
                                            • 92. Composition.section:allergies_and_intolerances_section.entry:allergy_intolerance_entry
                                              Slice Nameallergy_intolerance_entry
                                              Definition

                                              A reference to the actual resource from which the narrative in the section is derived.

                                              ShortA reference to data that supports this section
                                              Comments

                                              If there are no entries in the list, an emptyReason SHOULD be provided.

                                              Control0..*
                                              This element is affected by the following invariants: cmp-2
                                              TypeReference(US Core AllergyIntolerance Profile, Resource)
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              94. Composition.section:history_of_present_illness_section
                                              Slice Namehistory_of_present_illness_section
                                              Definition

                                              The root of the sections that make up the composition.

                                              ShortHistory of Present Illness SectionComposition is broken into sections
                                              Comments

                                              History of Present Illness Section

                                              Control10..1*
                                              TypeBackboneElement
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              LabelHistory of Present Illness Section
                                              Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                              96. Composition.section:history_of_present_illness_section.modifierExtension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                              ShortExtensions that cannot be ignored even if unrecognized
                                              Comments

                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                              Control0..*
                                              TypeExtension
                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                              Summarytrue
                                              Requirements

                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.


                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                              Alternate Namesextensions, user content, modifiers
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              98. Composition.section:history_of_present_illness_section.title
                                              Definition

                                              The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                              ShorttitleLabel for section (e.g. for ToC)
                                              Comments

                                              The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                              Control10..1
                                              Typestring
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supporttrue
                                              Summaryfalse
                                              Requirements

                                              Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                              Alternate Namesheader, label, caption
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              100. Composition.section:history_of_present_illness_section.code
                                              Definition

                                              A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                              ShortHistory of present illnessClassification of section (recommended)
                                              Comments

                                              The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                              If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                              Control10..1
                                              BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                              (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                              Classification of a section of a composition/document.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              Requirements

                                              Provides computable standardized labels to topics within the document.

                                              LabelHistory of present illness
                                              Pattern Value{
                                                "coding" : [{
                                                  "system" : "http://loinc.org",
                                                  "code" : "10164-2"
                                                }]
                                              }
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              102. Composition.section:history_of_present_illness_section.text
                                              Definition

                                              A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                              ShortThis section contains only human readable contentText summary of the section, for human interpretation
                                              Comments

                                              Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                              Control10..1
                                              This element is affected by the following invariants: cmp-1
                                              TypeNarrative
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              104. Composition.section:problem_section
                                              Slice Nameproblem_section
                                              Definition

                                              The root of the sections that make up the composition.

                                              ShortProblem SectionComposition is broken into sections
                                              Comments

                                              Problem Section

                                              Control10..1*
                                              TypeBackboneElement
                                              Is Modifierfalse
                                              Summaryfalse
                                              LabelProblem Section
                                              Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                              106. Composition.section:problem_section.modifierExtension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                              ShortExtensions that cannot be ignored even if unrecognized
                                              Comments

                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                              Control0..*
                                              TypeExtension
                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                              Summarytrue
                                              Requirements

                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.


                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                              Alternate Namesextensions, user content, modifiers
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              108. Composition.section:problem_section.title
                                              Definition

                                              The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                              ShorttitleLabel for section (e.g. for ToC)
                                              Comments

                                              The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                              Control10..1
                                              Typestring
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supporttrue
                                              Summaryfalse
                                              Requirements

                                              Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                              Alternate Namesheader, label, caption
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              110. Composition.section:problem_section.code
                                              Definition

                                              A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                              ShortProblem listClassification of section (recommended)
                                              Comments

                                              The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                              If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                              Control10..1
                                              BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                              (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                              Classification of a section of a composition/document.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              Requirements

                                              Provides computable standardized labels to topics within the document.

                                              LabelProblem list
                                              Pattern Value{
                                                "coding" : [{
                                                  "system" : "http://loinc.org",
                                                  "code" : "11450-4"
                                                }]
                                              }
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              112. Composition.section:problem_section.text
                                              Definition

                                              A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                              ShorttextText summary of the section, for human interpretation
                                              Comments

                                              Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                              Control10..1
                                              This element is affected by the following invariants: cmp-1
                                              TypeNarrative
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              114. Composition.section:problem_section.entry
                                              Definition

                                              A reference to the actual resource from which the narrative in the section is derived.

                                              ShortentryA reference to data that supports this section
                                              Comments

                                              If there are no entries in the list, an emptyReason SHOULD be provided.

                                              Control0..*
                                              This element is affected by the following invariants: cmp-2
                                              TypeReference(Resource)
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                              • profile @ resolve()
                                              • 116. Composition.section:problem_section.entry:problem_section_entry
                                                Slice Nameproblem_section_entry
                                                Definition

                                                A reference to the actual resource from which the narrative in the section is derived.

                                                ShortA reference to data that supports this section
                                                Comments

                                                If there are no entries in the list, an emptyReason SHOULD be provided.

                                                Control0..*
                                                This element is affected by the following invariants: cmp-2
                                                TypeReference(US Core Condition Profile, Resource)
                                                Is Modifierfalse
                                                Must Supporttrue
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                118. Composition.section:medications_section
                                                Slice Namemedications_section
                                                Definition

                                                The root of the sections that make up the composition.

                                                ShortMedications SectionComposition is broken into sections
                                                Comments

                                                Medications Section

                                                Control0..1*
                                                TypeBackboneElement
                                                Is Modifierfalse
                                                Summaryfalse
                                                LabelMedications Section
                                                Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                120. Composition.section:medications_section.modifierExtension
                                                Definition

                                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                ShortExtensions that cannot be ignored even if unrecognized
                                                Comments

                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                Control0..*
                                                TypeExtension
                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                Summarytrue
                                                Requirements

                                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.


                                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                Alternate Namesextensions, user content, modifiers
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                122. Composition.section:medications_section.title
                                                Definition

                                                The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                ShorttitleLabel for section (e.g. for ToC)
                                                Comments

                                                The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                Control10..1
                                                Typestring
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summaryfalse
                                                Requirements

                                                Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                Alternate Namesheader, label, caption
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                124. Composition.section:medications_section.code
                                                Definition

                                                A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                ShortHistory of medication useClassification of section (recommended)
                                                Comments

                                                The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                Control10..1
                                                BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                                (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                Classification of a section of a composition/document.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Summaryfalse
                                                Requirements

                                                Provides computable standardized labels to topics within the document.

                                                LabelHistory of medication use
                                                Pattern Value{
                                                  "coding" : [{
                                                    "system" : "http://loinc.org",
                                                    "code" : "10160-0"
                                                  }]
                                                }
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                126. Composition.section:medications_section.text
                                                Definition

                                                A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                ShorttextText summary of the section, for human interpretation
                                                Comments

                                                Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                Control10..1
                                                This element is affected by the following invariants: cmp-1
                                                TypeNarrative
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                128. Composition.section:medications_section.entry
                                                Definition

                                                A reference to the actual resource from which the narrative in the section is derived.

                                                ShortentryA reference to data that supports this section
                                                Comments

                                                If there are no entries in the list, an emptyReason SHOULD be provided.

                                                Control0..*
                                                This element is affected by the following invariants: cmp-2
                                                TypeReference(Resource)
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                • profile @ resolve()
                                                • 130. Composition.section:medications_section.entry:sliceEntry
                                                  Slice NamesliceEntry
                                                  Definition

                                                  A reference to the actual resource from which the narrative in the section is derived.

                                                  ShortA reference to data that supports this section
                                                  Comments

                                                  If there are no entries in the list, an emptyReason SHOULD be provided.

                                                  Control0..*
                                                  This element is affected by the following invariants: cmp-2
                                                  TypeReference(MedicationStatement, US Core Medication Profile, US Core MedicationRequest Profile, Resource)
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  132. Composition.section:physical_exam_section
                                                  Slice Namephysical_exam_section
                                                  Definition

                                                  The root of the sections that make up the composition.

                                                  ShortPhysical Exam SectionComposition is broken into sections
                                                  Comments

                                                  Physical Exam Section

                                                  Control0..1*
                                                  TypeBackboneElement
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  LabelPhysical Exam Section
                                                  Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                  cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                  ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                  cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                  134. Composition.section:physical_exam_section.modifierExtension
                                                  Definition

                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                  Comments

                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                  Control0..*
                                                  TypeExtension
                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                  Summarytrue
                                                  Requirements

                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.


                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                  Alternate Namesextensions, user content, modifiers
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                  136. Composition.section:physical_exam_section.title
                                                  Definition

                                                  The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                  ShorttitleLabel for section (e.g. for ToC)
                                                  Comments

                                                  The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                  Control10..1
                                                  Typestring
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summaryfalse
                                                  Requirements

                                                  Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                  Alternate Namesheader, label, caption
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  138. Composition.section:physical_exam_section.code
                                                  Definition

                                                  A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                  ShortPhysical findingsClassification of section (recommended)
                                                  Comments

                                                  The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                  If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                  Control10..1
                                                  BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                                  (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                  Classification of a section of a composition/document.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Provides computable standardized labels to topics within the document.

                                                  LabelPhysical findings
                                                  Pattern Value{
                                                    "coding" : [{
                                                      "system" : "http://loinc.org",
                                                      "code" : "29545-1"
                                                    }]
                                                  }
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  140. Composition.section:physical_exam_section.text
                                                  Definition

                                                  A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                  ShorttextText summary of the section, for human interpretation
                                                  Comments

                                                  Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                  Control10..1
                                                  This element is affected by the following invariants: cmp-1
                                                  TypeNarrative
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  142. Composition.section:physical_exam_section.entry
                                                  Definition

                                                  A reference to the actual resource from which the narrative in the section is derived.

                                                  ShortentryA reference to data that supports this section
                                                  Comments

                                                  If there are no entries in the list, an emptyReason SHOULD be provided.

                                                  Control0..*
                                                  This element is affected by the following invariants: cmp-2
                                                  TypeReference(Resource)
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                  • profile @ resolve()
                                                  • 144. Composition.section:physical_exam_section.entry:sliceEntry
                                                    Slice NamesliceEntry
                                                    Definition

                                                    A reference to the actual resource from which the narrative in the section is derived.

                                                    ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.A reference to data that supports this section
                                                    Comments

                                                    If there are no entries in the list, an emptyReason SHOULD be provided.

                                                    Control0..*
                                                    This element is affected by the following invariants: cmp-2
                                                    TypeReference(Observation, Resource)
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    146. Composition.section:results_section
                                                    Slice Nameresults_section
                                                    Definition

                                                    The root of the sections that make up the composition.

                                                    ShortResults SectionComposition is broken into sections
                                                    Comments

                                                    Results Section

                                                    Control0..1*
                                                    TypeBackboneElement
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    LabelResults Section
                                                    Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                    148. Composition.section:results_section.modifierExtension
                                                    Definition

                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                    Comments

                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                    Control0..*
                                                    TypeExtension
                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                    Summarytrue
                                                    Requirements

                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.


                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                    Alternate Namesextensions, user content, modifiers
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    150. Composition.section:results_section.title
                                                    Definition

                                                    The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                    ShorttitleLabel for section (e.g. for ToC)
                                                    Comments

                                                    The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                    Control10..1
                                                    Typestring
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Summaryfalse
                                                    Requirements

                                                    Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                    Alternate Namesheader, label, caption
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    152. Composition.section:results_section.code
                                                    Definition

                                                    A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                    ShortRelevant diagnostic tests/laboratory dataClassification of section (recommended)
                                                    Comments

                                                    The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                    If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                    Control10..1
                                                    BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                                    (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                    Classification of a section of a composition/document.

                                                    TypeCodeableConcept
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Provides computable standardized labels to topics within the document.

                                                    LabelRelevant diagnostic tests/laboratory data
                                                    Pattern Value{
                                                      "coding" : [{
                                                        "system" : "http://loinc.org",
                                                        "code" : "30954-2"
                                                      }]
                                                    }
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    154. Composition.section:results_section.text
                                                    Definition

                                                    A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                    ShorttextText summary of the section, for human interpretation
                                                    Comments

                                                    Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                    Control10..1
                                                    This element is affected by the following invariants: cmp-1
                                                    TypeNarrative
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    156. Composition.section:results_section.entry
                                                    Definition

                                                    A reference to the actual resource from which the narrative in the section is derived.

                                                    ShortentryA reference to data that supports this section
                                                    Comments

                                                    If there are no entries in the list, an emptyReason SHOULD be provided.

                                                    Control0..*
                                                    This element is affected by the following invariants: cmp-2
                                                    TypeReference(Resource)
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                    • profile @ resolve()
                                                    • 158. Composition.section:results_section.entry:sliceEntry
                                                      Slice NamesliceEntry
                                                      Definition

                                                      A reference to the actual resource from which the narrative in the section is derived.

                                                      ShortA reference to data that supports this section
                                                      Comments

                                                      If there are no entries in the list, an emptyReason SHOULD be provided.

                                                      Control0..*
                                                      This element is affected by the following invariants: cmp-2
                                                      TypeReference(US Core Laboratory Result Observation Profile, Resource)
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      160. Composition.section:advance_directives_section
                                                      Slice Nameadvance_directives_section
                                                      Definition

                                                      The root of the sections that make up the composition.

                                                      ShortAdvance Directives SectionComposition is broken into sections
                                                      Comments

                                                      Advance Directives Section

                                                      Control0..1*
                                                      TypeBackboneElement
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Summaryfalse
                                                      LabelAdvance Directives Section
                                                      Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                      162. Composition.section:advance_directives_section.modifierExtension
                                                      Definition

                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                      Comments

                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                      Control0..*
                                                      TypeExtension
                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                      Summarytrue
                                                      Requirements

                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.


                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                      Alternate Namesextensions, user content, modifiers
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      164. Composition.section:advance_directives_section.title
                                                      Definition

                                                      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                      ShorttitleLabel for section (e.g. for ToC)
                                                      Comments

                                                      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                      Control10..1
                                                      Typestring
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Must Supporttrue
                                                      Summaryfalse
                                                      Requirements

                                                      Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                      Alternate Namesheader, label, caption
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      166. Composition.section:advance_directives_section.code
                                                      Definition

                                                      A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                      ShortAdvance directivesClassification of section (recommended)
                                                      Comments

                                                      The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                      Control10..1
                                                      BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                                      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                      Classification of a section of a composition/document.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Summaryfalse
                                                      Requirements

                                                      Provides computable standardized labels to topics within the document.

                                                      LabelAdvance directives
                                                      Pattern Value{
                                                        "coding" : [{
                                                          "system" : "http://loinc.org",
                                                          "code" : "42348-3"
                                                        }]
                                                      }
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      168. Composition.section:advance_directives_section.text
                                                      Definition

                                                      A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                      ShorttextText summary of the section, for human interpretation
                                                      Comments

                                                      Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                      Control10..1
                                                      This element is affected by the following invariants: cmp-1
                                                      TypeNarrative
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      170. Composition.section:advance_directives_section.entry
                                                      Definition

                                                      A reference to the actual resource from which the narrative in the section is derived.

                                                      ShortA reference to data that supports this section
                                                      Comments

                                                      If there are no entries in the list, an emptyReason SHOULD be provided.

                                                      Control0..*
                                                      This element is affected by the following invariants: cmp-2
                                                      TypeReference(Resource)
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                      • profile @ resolve()
                                                      • 172. Composition.section:advance_directives_section.entry:advance_directive_entry
                                                        Slice Nameadvance_directive_entry
                                                        Definition

                                                        A reference to the actual resource from which the narrative in the section is derived.

                                                        ShortA reference to data that supports this section
                                                        Comments

                                                        If there are no entries in the list, an emptyReason SHOULD be provided.

                                                        Control0..*
                                                        This element is affected by the following invariants: cmp-2
                                                        TypeReference(Consent, Resource)
                                                        Is Modifierfalse
                                                        Must Supporttrue
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        174. Composition.section:assessment_and_plan_section
                                                        Slice Nameassessment_and_plan_section
                                                        Definition

                                                        The root of the sections that make up the composition.

                                                        ShortAssessment and Plan Section. This section represents the clinician’s conclusions and working assumptions that will guide treatment of the patient. The Assessment and Plan Section may be combined or separated to meet local policy requirements.Composition is broken into sections
                                                        Comments

                                                        Assessment and Plan Section

                                                        Control0..1*
                                                        TypeBackboneElement
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        LabelAssessment and Plan Section
                                                        Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                        cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                        cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                        176. Composition.section:assessment_and_plan_section.modifierExtension
                                                        Definition

                                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                        Comments

                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                        Control0..*
                                                        TypeExtension
                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                        Summarytrue
                                                        Requirements

                                                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.


                                                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                        Alternate Namesextensions, user content, modifiers
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        178. Composition.section:assessment_and_plan_section.title
                                                        Definition

                                                        The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                        ShorttitleLabel for section (e.g. for ToC)
                                                        Comments

                                                        The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                        Control10..1
                                                        Typestring
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summaryfalse
                                                        Requirements

                                                        Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                        Alternate Namesheader, label, caption
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        180. Composition.section:assessment_and_plan_section.code
                                                        Definition

                                                        A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                        ShortAssessment (evaluation) and planClassification of section (recommended)
                                                        Comments

                                                        The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                        If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                        Control10..1
                                                        BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                                        (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                        Classification of a section of a composition/document.

                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Provides computable standardized labels to topics within the document.

                                                        LabelAssessment (evaluation) and plan
                                                        Pattern Value{
                                                          "coding" : [{
                                                            "system" : "http://loinc.org",
                                                            "code" : "51847-2"
                                                          }]
                                                        }
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        182. Composition.section:assessment_and_plan_section.text
                                                        Definition

                                                        A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                        ShorttextText summary of the section, for human interpretation
                                                        Comments

                                                        Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                        Control10..1
                                                        This element is affected by the following invariants: cmp-1
                                                        TypeNarrative
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        184. Composition.section:assessment_and_plan_section.entry
                                                        Definition

                                                        A reference to the actual resource from which the narrative in the section is derived.

                                                        ShortA reference to data that supports this section
                                                        Comments

                                                        If there are no entries in the list, an emptyReason SHOULD be provided.

                                                        Control0..*
                                                        This element is affected by the following invariants: cmp-2
                                                        TypeReference(Resource)
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                        • profile @ resolve()
                                                        • 186. Composition.section:assessment_and_plan_section.entry:sliceEntry
                                                          Slice NamesliceEntry
                                                          Definition

                                                          A reference to the actual resource from which the narrative in the section is derived.

                                                          ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.A reference to data that supports this section
                                                          Comments

                                                          If there are no entries in the list, an emptyReason SHOULD be provided.

                                                          Control0..*
                                                          This element is affected by the following invariants: cmp-2
                                                          TypeReference(US Core Condition Profile, Observation, Communication, Resource)
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          188. Composition.section:assessment_section
                                                          Slice Nameassessment_section
                                                          Definition

                                                          The root of the sections that make up the composition.

                                                          ShortAssessment SectionComposition is broken into sections
                                                          Comments

                                                          Assessment Section

                                                          Control0..1*
                                                          TypeBackboneElement
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          LabelAssessment Section
                                                          Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                          190. Composition.section:assessment_section.modifierExtension
                                                          Definition

                                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                          Comments

                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                          Control0..*
                                                          TypeExtension
                                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                          Summarytrue
                                                          Requirements

                                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.


                                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                          Alternate Namesextensions, user content, modifiers
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          192. Composition.section:assessment_section.title
                                                          Definition

                                                          The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                          ShorttitleLabel for section (e.g. for ToC)
                                                          Comments

                                                          The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                          Control10..1
                                                          Typestring
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summaryfalse
                                                          Requirements

                                                          Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                          Alternate Namesheader, label, caption
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          194. Composition.section:assessment_section.code
                                                          Definition

                                                          A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                          ShortAssessments (evaluation)Classification of section (recommended)
                                                          Comments

                                                          The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                          If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                          Control10..1
                                                          BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                                          (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                          Classification of a section of a composition/document.

                                                          TypeCodeableConcept
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Provides computable standardized labels to topics within the document.

                                                          LabelAssessments (evaluation)
                                                          Pattern Value{
                                                            "coding" : [{
                                                              "system" : "http://loinc.org",
                                                              "code" : "51848-0"
                                                            }]
                                                          }
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          196. Composition.section:assessment_section.text
                                                          Definition

                                                          A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                          ShortThis section contains only human readable contentText summary of the section, for human interpretation
                                                          Comments

                                                          Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                          Control10..1
                                                          This element is affected by the following invariants: cmp-1
                                                          TypeNarrative
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          198. Composition.section:chief_complaint_and_reason_for_visit_section
                                                          Slice Namechief_complaint_and_reason_for_visit_section
                                                          Definition

                                                          The root of the sections that make up the composition.

                                                          ShortChief Complaint and Reason for Visit Section. This section records the patient's chief complaint (the patient’s own description) and/or the reason for the patient's visit (the provider’s description of the reason for visit). Local policy determines whether the information is divided into two sections or recorded in one section serving both purposes.Composition is broken into sections
                                                          Comments

                                                          Chief Complaint and Reason for Visit Section

                                                          Control0..1*
                                                          TypeBackboneElement
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          LabelChief Complaint and Reason for Visit Section
                                                          Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                          200. Composition.section:chief_complaint_and_reason_for_visit_section.modifierExtension
                                                          Definition

                                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                          Comments

                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                          Control0..*
                                                          TypeExtension
                                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                          Summarytrue
                                                          Requirements

                                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.


                                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                          Alternate Namesextensions, user content, modifiers
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          202. Composition.section:chief_complaint_and_reason_for_visit_section.title
                                                          Definition

                                                          The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                          ShorttitleLabel for section (e.g. for ToC)
                                                          Comments

                                                          The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                          Control10..1
                                                          Typestring
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summaryfalse
                                                          Requirements

                                                          Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                          Alternate Namesheader, label, caption
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          204. Composition.section:chief_complaint_and_reason_for_visit_section.code
                                                          Definition

                                                          A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                          ShortChief complaint and reason for visitClassification of section (recommended)
                                                          Comments

                                                          The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                          If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                          Control10..1
                                                          BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                                          (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                          Classification of a section of a composition/document.

                                                          TypeCodeableConcept
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Provides computable standardized labels to topics within the document.

                                                          LabelChief complaint and reason for visit
                                                          Pattern Value{
                                                            "coding" : [{
                                                              "system" : "http://loinc.org",
                                                              "code" : "46239-0"
                                                            }]
                                                          }
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          206. Composition.section:chief_complaint_and_reason_for_visit_section.text
                                                          Definition

                                                          A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                          ShortThis section contains only human readable contentText summary of the section, for human interpretation
                                                          Comments

                                                          Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                          Control10..1
                                                          This element is affected by the following invariants: cmp-1
                                                          TypeNarrative
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          208. Composition.section:chief_complaint_section
                                                          Slice Namechief_complaint_section
                                                          Definition

                                                          The root of the sections that make up the composition.

                                                          ShortChief Complaint SectionComposition is broken into sections
                                                          Comments

                                                          Chief Complaint Section

                                                          Control0..1*
                                                          TypeBackboneElement
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          LabelChief Complaint Section
                                                          Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                          210. Composition.section:chief_complaint_section.modifierExtension
                                                          Definition

                                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                          Comments

                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                          Control0..*
                                                          TypeExtension
                                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                          Summarytrue
                                                          Requirements

                                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.


                                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                          Alternate Namesextensions, user content, modifiers
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          212. Composition.section:chief_complaint_section.title
                                                          Definition

                                                          The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                          ShorttitleLabel for section (e.g. for ToC)
                                                          Comments

                                                          The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                          Control10..1
                                                          Typestring
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summaryfalse
                                                          Requirements

                                                          Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                          Alternate Namesheader, label, caption
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          214. Composition.section:chief_complaint_section.code
                                                          Definition

                                                          A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                          ShortChief complaintClassification of section (recommended)
                                                          Comments

                                                          The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                          If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                          Control10..1
                                                          BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                                          (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                          Classification of a section of a composition/document.

                                                          TypeCodeableConcept
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Provides computable standardized labels to topics within the document.

                                                          LabelChief complaint
                                                          Pattern Value{
                                                            "coding" : [{
                                                              "system" : "http://loinc.org",
                                                              "code" : "10154-3"
                                                            }]
                                                          }
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          216. Composition.section:chief_complaint_section.text
                                                          Definition

                                                          A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                          ShortThis section contains only human readable contentText summary of the section, for human interpretation
                                                          Comments

                                                          Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                          Control10..1
                                                          This element is affected by the following invariants: cmp-1
                                                          TypeNarrative
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          218. Composition.section:family_history_section
                                                          Slice Namefamily_history_section
                                                          Definition

                                                          The root of the sections that make up the composition.

                                                          ShortFamily History SectionComposition is broken into sections
                                                          Comments

                                                          Family History Section

                                                          Control0..1*
                                                          TypeBackboneElement
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          LabelFamily History Section
                                                          Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                          220. Composition.section:family_history_section.modifierExtension
                                                          Definition

                                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                          Comments

                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                          Control0..*
                                                          TypeExtension
                                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                          Summarytrue
                                                          Requirements

                                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.


                                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                          Alternate Namesextensions, user content, modifiers
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          222. Composition.section:family_history_section.title
                                                          Definition

                                                          The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                          ShorttitleLabel for section (e.g. for ToC)
                                                          Comments

                                                          The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                          Control10..1
                                                          Typestring
                                                          Is Modifierfalse
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Summaryfalse
                                                          Requirements

                                                          Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                          Alternate Namesheader, label, caption
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          224. Composition.section:family_history_section.code
                                                          Definition

                                                          A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                          ShortFamily historyClassification of section (recommended)
                                                          Comments

                                                          The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                          If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                          Control10..1
                                                          BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                                          (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                          Classification of a section of a composition/document.

                                                          TypeCodeableConcept
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Provides computable standardized labels to topics within the document.

                                                          LabelFamily history
                                                          Pattern Value{
                                                            "coding" : [{
                                                              "system" : "http://loinc.org",
                                                              "code" : "10157-6"
                                                            }]
                                                          }
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          226. Composition.section:family_history_section.text
                                                          Definition

                                                          A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                          ShorttextText summary of the section, for human interpretation
                                                          Comments

                                                          Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                          Control10..1
                                                          This element is affected by the following invariants: cmp-1
                                                          TypeNarrative
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          228. Composition.section:family_history_section.entry
                                                          Definition

                                                          A reference to the actual resource from which the narrative in the section is derived.

                                                          ShortentryA reference to data that supports this section
                                                          Comments

                                                          If there are no entries in the list, an emptyReason SHOULD be provided.

                                                          Control0..*
                                                          This element is affected by the following invariants: cmp-2
                                                          TypeReference(Resource)
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                          • profile @ resolve()
                                                          • 230. Composition.section:family_history_section.entry:sliceEntry
                                                            Slice NamesliceEntry
                                                            Definition

                                                            A reference to the actual resource from which the narrative in the section is derived.

                                                            ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.A reference to data that supports this section
                                                            Comments

                                                            If there are no entries in the list, an emptyReason SHOULD be provided.

                                                            Control0..*
                                                            This element is affected by the following invariants: cmp-2
                                                            TypeReference(FamilyMemberHistory, Resource)
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            232. Composition.section:functional_status_section
                                                            Slice Namefunctional_status_section
                                                            Definition

                                                            The root of the sections that make up the composition.

                                                            ShortFunctional Status SectionComposition is broken into sections
                                                            Comments

                                                            Functional Status Section

                                                            Control0..1*
                                                            TypeBackboneElement
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            LabelFunctional Status Section
                                                            Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                            234. Composition.section:functional_status_section.modifierExtension
                                                            Definition

                                                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                            Comments

                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                            Control0..*
                                                            TypeExtension
                                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                            Summarytrue
                                                            Requirements

                                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.


                                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                            Alternate Namesextensions, user content, modifiers
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            236. Composition.section:functional_status_section.title
                                                            Definition

                                                            The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                            ShorttitleLabel for section (e.g. for ToC)
                                                            Comments

                                                            The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                            Control10..1
                                                            Typestring
                                                            Is Modifierfalse
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            Summaryfalse
                                                            Requirements

                                                            Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                            Alternate Namesheader, label, caption
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            238. Composition.section:functional_status_section.code
                                                            Definition

                                                            A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                            ShortFunctional statusClassification of section (recommended)
                                                            Comments

                                                            The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                            If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                            Control10..1
                                                            BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                                            (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                            Classification of a section of a composition/document.

                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Provides computable standardized labels to topics within the document.

                                                            LabelFunctional status
                                                            Pattern Value{
                                                              "coding" : [{
                                                                "system" : "http://loinc.org",
                                                                "code" : "47420-5"
                                                              }]
                                                            }
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            240. Composition.section:functional_status_section.text
                                                            Definition

                                                            A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                            ShorttextText summary of the section, for human interpretation
                                                            Comments

                                                            Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                            Control10..1
                                                            This element is affected by the following invariants: cmp-1
                                                            TypeNarrative
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            242. Composition.section:functional_status_section.entry
                                                            Definition

                                                            A reference to the actual resource from which the narrative in the section is derived.

                                                            ShortentryA reference to data that supports this section
                                                            Comments

                                                            If there are no entries in the list, an emptyReason SHOULD be provided.

                                                            Control0..*
                                                            This element is affected by the following invariants: cmp-2
                                                            TypeReference(Resource)
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                            • profile @ resolve()
                                                            • 244. Composition.section:functional_status_section.entry:sliceEntry
                                                              Slice NamesliceEntry
                                                              Definition

                                                              A reference to the actual resource from which the narrative in the section is derived.

                                                              ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.A reference to data that supports this section
                                                              Comments

                                                              If there are no entries in the list, an emptyReason SHOULD be provided.

                                                              Control0..*
                                                              This element is affected by the following invariants: cmp-2
                                                              TypeReference(Observation, Resource)
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              246. Composition.section:general_status_section
                                                              Slice Namegeneral_status_section
                                                              Definition

                                                              The root of the sections that make up the composition.

                                                              ShortGeneral Status SectionComposition is broken into sections
                                                              Comments

                                                              General Status Section

                                                              Control0..1*
                                                              TypeBackboneElement
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              LabelGeneral Status Section
                                                              Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                              248. Composition.section:general_status_section.modifierExtension
                                                              Definition

                                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                              Comments

                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                              Control0..*
                                                              TypeExtension
                                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                              Summarytrue
                                                              Requirements

                                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.


                                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                              Alternate Namesextensions, user content, modifiers
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                              250. Composition.section:general_status_section.title
                                                              Definition

                                                              The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                              ShorttitleLabel for section (e.g. for ToC)
                                                              Comments

                                                              The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                              Control10..1
                                                              Typestring
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summaryfalse
                                                              Requirements

                                                              Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                              Alternate Namesheader, label, caption
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              252. Composition.section:general_status_section.code
                                                              Definition

                                                              A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                              ShortPhysical findings of General statusClassification of section (recommended)
                                                              Comments

                                                              The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                              If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                              Control10..1
                                                              BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                                              (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                              Classification of a section of a composition/document.

                                                              TypeCodeableConcept
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Provides computable standardized labels to topics within the document.

                                                              LabelPhysical findings of General status
                                                              Pattern Value{
                                                                "coding" : [{
                                                                  "system" : "http://loinc.org",
                                                                  "code" : "10210-3"
                                                                }]
                                                              }
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              254. Composition.section:general_status_section.text
                                                              Definition

                                                              A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                              ShortThis section contains only human readable contentText summary of the section, for human interpretation
                                                              Comments

                                                              Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                              Control10..1
                                                              This element is affected by the following invariants: cmp-1
                                                              TypeNarrative
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              256. Composition.section:past_medical_history_section
                                                              Slice Namepast_medical_history_section
                                                              Definition

                                                              The root of the sections that make up the composition.

                                                              ShortPast Medical History SectionComposition is broken into sections
                                                              Comments

                                                              Past Medical History Section

                                                              Control0..1*
                                                              TypeBackboneElement
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              LabelPast Medical History Section
                                                              Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                              258. Composition.section:past_medical_history_section.modifierExtension
                                                              Definition

                                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                              Comments

                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                              Control0..*
                                                              TypeExtension
                                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                              Summarytrue
                                                              Requirements

                                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.


                                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                              Alternate Namesextensions, user content, modifiers
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                              260. Composition.section:past_medical_history_section.title
                                                              Definition

                                                              The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                              ShorttitleLabel for section (e.g. for ToC)
                                                              Comments

                                                              The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                              Control10..1
                                                              Typestring
                                                              Is Modifierfalse
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summaryfalse
                                                              Requirements

                                                              Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                              Alternate Namesheader, label, caption
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              262. Composition.section:past_medical_history_section.code
                                                              Definition

                                                              A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                              ShortPast Medical HistoryClassification of section (recommended)
                                                              Comments

                                                              The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                              If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                              Control10..1
                                                              BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                                              (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                              Classification of a section of a composition/document.

                                                              TypeCodeableConcept
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Requirements

                                                              Provides computable standardized labels to topics within the document.

                                                              LabelPast Medical History
                                                              Pattern Value{
                                                                "coding" : [{
                                                                  "system" : "http://loinc.org",
                                                                  "code" : "11348-0"
                                                                }]
                                                              }
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              264. Composition.section:past_medical_history_section.text
                                                              Definition

                                                              A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                              ShorttextText summary of the section, for human interpretation
                                                              Comments

                                                              Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                              Control10..1
                                                              This element is affected by the following invariants: cmp-1
                                                              TypeNarrative
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              266. Composition.section:past_medical_history_section.entry
                                                              Definition

                                                              A reference to the actual resource from which the narrative in the section is derived.

                                                              ShortentryA reference to data that supports this section
                                                              Comments

                                                              If there are no entries in the list, an emptyReason SHOULD be provided.

                                                              Control0..*
                                                              This element is affected by the following invariants: cmp-2
                                                              TypeReference(Resource)
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                              • profile @ resolve()
                                                              • 268. Composition.section:past_medical_history_section.entry:sliceEntry
                                                                Slice NamesliceEntry
                                                                Definition

                                                                A reference to the actual resource from which the narrative in the section is derived.

                                                                ShortA reference to data that supports this section
                                                                Comments

                                                                If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                Control0..*
                                                                This element is affected by the following invariants: cmp-2
                                                                TypeReference(US Core Condition Profile, Resource)
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                270. Composition.section:immunizations_section
                                                                Slice Nameimmunizations_section
                                                                Definition

                                                                The root of the sections that make up the composition.

                                                                ShortImmunizations SectionComposition is broken into sections
                                                                Comments

                                                                Immunizations Section

                                                                Control0..1*
                                                                TypeBackboneElement
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                LabelImmunizations Section
                                                                Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                272. Composition.section:immunizations_section.modifierExtension
                                                                Definition

                                                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                Comments

                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                Control0..*
                                                                TypeExtension
                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                Summarytrue
                                                                Requirements

                                                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.


                                                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                Alternate Namesextensions, user content, modifiers
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                274. Composition.section:immunizations_section.title
                                                                Definition

                                                                The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                ShorttitleLabel for section (e.g. for ToC)
                                                                Comments

                                                                The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                Control10..1
                                                                Typestring
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Summaryfalse
                                                                Requirements

                                                                Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                Alternate Namesheader, label, caption
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                276. Composition.section:immunizations_section.code
                                                                Definition

                                                                A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                ShortHistory of immunizationClassification of section (recommended)
                                                                Comments

                                                                The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                Control10..1
                                                                BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                                                (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                Classification of a section of a composition/document.

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Provides computable standardized labels to topics within the document.

                                                                LabelHistory of immunization
                                                                Pattern Value{
                                                                  "coding" : [{
                                                                    "system" : "http://loinc.org",
                                                                    "code" : "11369-6"
                                                                  }]
                                                                }
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                278. Composition.section:immunizations_section.text
                                                                Definition

                                                                A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                ShorttextText summary of the section, for human interpretation
                                                                Comments

                                                                Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                Control10..1
                                                                This element is affected by the following invariants: cmp-1
                                                                TypeNarrative
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                280. Composition.section:immunizations_section.entry
                                                                Definition

                                                                A reference to the actual resource from which the narrative in the section is derived.

                                                                ShortentryA reference to data that supports this section
                                                                Comments

                                                                If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                Control0..*
                                                                This element is affected by the following invariants: cmp-2
                                                                TypeReference(Resource)
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                • profile @ resolve()
                                                                • 282. Composition.section:immunizations_section.entry:sliceEntry
                                                                  Slice NamesliceEntry
                                                                  Definition

                                                                  A reference to the actual resource from which the narrative in the section is derived.

                                                                  ShortA reference to data that supports this section
                                                                  Comments

                                                                  If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                  Control0..*
                                                                  This element is affected by the following invariants: cmp-2
                                                                  TypeReference(US Core Immunization Profile, Resource)
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  284. Composition.section:medical_equipment_section
                                                                  Slice Namemedical_equipment_section
                                                                  Definition

                                                                  The root of the sections that make up the composition.

                                                                  ShortMedical Equipment SectionComposition is broken into sections
                                                                  Comments

                                                                  Medical Equipment Section

                                                                  Control0..1*
                                                                  TypeBackboneElement
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  LabelMedical Equipment Section
                                                                  Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                  cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                  ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                  cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                  286. Composition.section:medical_equipment_section.modifierExtension
                                                                  Definition

                                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                                  Comments

                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                  Control0..*
                                                                  TypeExtension
                                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                  Summarytrue
                                                                  Requirements

                                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.


                                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                  Alternate Namesextensions, user content, modifiers
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  288. Composition.section:medical_equipment_section.title
                                                                  Definition

                                                                  The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                  ShorttitleLabel for section (e.g. for ToC)
                                                                  Comments

                                                                  The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                  Control10..1
                                                                  Typestring
                                                                  Is Modifierfalse
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                  Alternate Namesheader, label, caption
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  290. Composition.section:medical_equipment_section.code
                                                                  Definition

                                                                  A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                  ShortHistory of medical device useClassification of section (recommended)
                                                                  Comments

                                                                  The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                  If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                  Control10..1
                                                                  BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                                                  (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                  Classification of a section of a composition/document.

                                                                  TypeCodeableConcept
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Provides computable standardized labels to topics within the document.

                                                                  LabelHistory of medical device use
                                                                  Pattern Value{
                                                                    "coding" : [{
                                                                      "system" : "http://loinc.org",
                                                                      "code" : "46264-8"
                                                                    }]
                                                                  }
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  292. Composition.section:medical_equipment_section.text
                                                                  Definition

                                                                  A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                  ShorttextText summary of the section, for human interpretation
                                                                  Comments

                                                                  Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                  Control10..1
                                                                  This element is affected by the following invariants: cmp-1
                                                                  TypeNarrative
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  294. Composition.section:medical_equipment_section.entry
                                                                  Definition

                                                                  A reference to the actual resource from which the narrative in the section is derived.

                                                                  ShortentryA reference to data that supports this section
                                                                  Comments

                                                                  If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                  Control0..*
                                                                  This element is affected by the following invariants: cmp-2
                                                                  TypeReference(Resource)
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                  • profile @ resolve()
                                                                  • 296. Composition.section:medical_equipment_section.entry:medical_equipment_entry
                                                                    Slice Namemedical_equipment_entry
                                                                    Definition

                                                                    A reference to the actual resource from which the narrative in the section is derived.

                                                                    ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.A reference to data that supports this section
                                                                    Comments

                                                                    If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                    Control0..*
                                                                    This element is affected by the following invariants: cmp-2
                                                                    TypeReference(Device, US Core Procedure Profile, Resource)
                                                                    Is Modifierfalse
                                                                    Must Supporttrue
                                                                    Must Support TypesNo must-support rules about the choice of types/profiles
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    298. Composition.section:mental_status_section
                                                                    Slice Namemental_status_section
                                                                    Definition

                                                                    The root of the sections that make up the composition.

                                                                    ShortMental Status SectionComposition is broken into sections
                                                                    Comments

                                                                    Mental Status Section

                                                                    Control0..1*
                                                                    TypeBackboneElement
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    LabelMental Status Section
                                                                    Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                    300. Composition.section:mental_status_section.modifierExtension
                                                                    Definition

                                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                    Comments

                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                    Control0..*
                                                                    TypeExtension
                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                    Summarytrue
                                                                    Requirements

                                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.


                                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                    Alternate Namesextensions, user content, modifiers
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    302. Composition.section:mental_status_section.title
                                                                    Definition

                                                                    The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                    ShorttitleLabel for section (e.g. for ToC)
                                                                    Comments

                                                                    The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                    Control10..1
                                                                    Typestring
                                                                    Is Modifierfalse
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                    Alternate Namesheader, label, caption
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    304. Composition.section:mental_status_section.code
                                                                    Definition

                                                                    A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                    ShortMental statusClassification of section (recommended)
                                                                    Comments

                                                                    The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                    If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                    Control10..1
                                                                    BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                                                    (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                    Classification of a section of a composition/document.

                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Provides computable standardized labels to topics within the document.

                                                                    LabelMental status
                                                                    Pattern Value{
                                                                      "coding" : [{
                                                                        "system" : "http://loinc.org",
                                                                        "code" : "10190-7"
                                                                      }]
                                                                    }
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    306. Composition.section:mental_status_section.text
                                                                    Definition

                                                                    A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                    ShorttextText summary of the section, for human interpretation
                                                                    Comments

                                                                    Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                    Control10..1
                                                                    This element is affected by the following invariants: cmp-1
                                                                    TypeNarrative
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    308. Composition.section:mental_status_section.entry
                                                                    Definition

                                                                    A reference to the actual resource from which the narrative in the section is derived.

                                                                    ShortentryA reference to data that supports this section
                                                                    Comments

                                                                    If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                    Control0..*
                                                                    This element is affected by the following invariants: cmp-2
                                                                    TypeReference(Resource)
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                    • profile @ resolve()
                                                                    • 310. Composition.section:mental_status_section.entry:sliceEntry
                                                                      Slice NamesliceEntry
                                                                      Definition

                                                                      A reference to the actual resource from which the narrative in the section is derived.

                                                                      ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.A reference to data that supports this section
                                                                      Comments

                                                                      If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                      Control0..*
                                                                      This element is affected by the following invariants: cmp-2
                                                                      TypeReference(Observation, Resource)
                                                                      Is Modifierfalse
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      312. Composition.section:nutrition_section
                                                                      Slice Namenutrition_section
                                                                      Definition

                                                                      The root of the sections that make up the composition.

                                                                      ShortNutrition SectionComposition is broken into sections
                                                                      Comments

                                                                      Nutrition Section

                                                                      Control0..1*
                                                                      TypeBackboneElement
                                                                      Is Modifierfalse
                                                                      Summaryfalse
                                                                      LabelNutrition Section
                                                                      Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                      314. Composition.section:nutrition_section.modifierExtension
                                                                      Definition

                                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                                      Comments

                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                      Control0..*
                                                                      TypeExtension
                                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                      Summarytrue
                                                                      Requirements

                                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.


                                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                      Alternate Namesextensions, user content, modifiers
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                      316. Composition.section:nutrition_section.title
                                                                      Definition

                                                                      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                      ShorttitleLabel for section (e.g. for ToC)
                                                                      Comments

                                                                      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                      Control10..1
                                                                      Typestring
                                                                      Is Modifierfalse
                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                      Summaryfalse
                                                                      Requirements

                                                                      Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                      Alternate Namesheader, label, caption
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      318. Composition.section:nutrition_section.code
                                                                      Definition

                                                                      A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                      ShortDiet and nutritionClassification of section (recommended)
                                                                      Comments

                                                                      The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                      Control10..1
                                                                      BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                                                      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                      Classification of a section of a composition/document.

                                                                      TypeCodeableConcept
                                                                      Is Modifierfalse
                                                                      Summaryfalse
                                                                      Requirements

                                                                      Provides computable standardized labels to topics within the document.

                                                                      LabelDiet and nutrition
                                                                      Pattern Value{
                                                                        "coding" : [{
                                                                          "system" : "http://loinc.org",
                                                                          "code" : "61144-2"
                                                                        }]
                                                                      }
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      320. Composition.section:nutrition_section.text
                                                                      Definition

                                                                      A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                      ShorttextText summary of the section, for human interpretation
                                                                      Comments

                                                                      Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                      Control10..1
                                                                      This element is affected by the following invariants: cmp-1
                                                                      TypeNarrative
                                                                      Is Modifierfalse
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      322. Composition.section:nutrition_section.entry
                                                                      Definition

                                                                      A reference to the actual resource from which the narrative in the section is derived.

                                                                      ShortentryA reference to data that supports this section
                                                                      Comments

                                                                      If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                      Control0..*
                                                                      This element is affected by the following invariants: cmp-2
                                                                      TypeReference(Resource)
                                                                      Is Modifierfalse
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                      • profile @ resolve()
                                                                      • 324. Composition.section:nutrition_section.entry:sliceEntry
                                                                        Slice NamesliceEntry
                                                                        Definition

                                                                        A reference to the actual resource from which the narrative in the section is derived.

                                                                        ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.A reference to data that supports this section
                                                                        Comments

                                                                        If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                        Control0..*
                                                                        This element is affected by the following invariants: cmp-2
                                                                        TypeReference(NutritionOrder, ClinicalImpression, Resource)
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        326. Composition.section:plan_of_treatment_section
                                                                        Slice Nameplan_of_treatment_section
                                                                        Definition

                                                                        The root of the sections that make up the composition.

                                                                        ShortPlan of Treatment SectionComposition is broken into sections
                                                                        Comments

                                                                        Plan of Treatment Section

                                                                        Control0..1*
                                                                        TypeBackboneElement
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        LabelPlan of Treatment Section
                                                                        Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                        cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                        cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                        328. Composition.section:plan_of_treatment_section.modifierExtension
                                                                        Definition

                                                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                                        Comments

                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                        Control0..*
                                                                        TypeExtension
                                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                        Summarytrue
                                                                        Requirements

                                                                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.


                                                                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                        Alternate Namesextensions, user content, modifiers
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        330. Composition.section:plan_of_treatment_section.title
                                                                        Definition

                                                                        The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                        ShorttitleLabel for section (e.g. for ToC)
                                                                        Comments

                                                                        The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                        Control10..1
                                                                        Typestring
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                        Alternate Namesheader, label, caption
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        332. Composition.section:plan_of_treatment_section.code
                                                                        Definition

                                                                        A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                        ShortPlan of treatmentClassification of section (recommended)
                                                                        Comments

                                                                        The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                        If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                        Control10..1
                                                                        BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                                                        (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                        Classification of a section of a composition/document.

                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Provides computable standardized labels to topics within the document.

                                                                        LabelPlan of treatment
                                                                        Pattern Value{
                                                                          "coding" : [{
                                                                            "system" : "http://loinc.org",
                                                                            "code" : "18776-5"
                                                                          }]
                                                                        }
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        334. Composition.section:plan_of_treatment_section.text
                                                                        Definition

                                                                        A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                        ShorttextText summary of the section, for human interpretation
                                                                        Comments

                                                                        Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                        Control10..1
                                                                        This element is affected by the following invariants: cmp-1
                                                                        TypeNarrative
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        336. Composition.section:plan_of_treatment_section.entry
                                                                        Definition

                                                                        A reference to the actual resource from which the narrative in the section is derived.

                                                                        ShortentryA reference to data that supports this section
                                                                        Comments

                                                                        If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                        Control0..*
                                                                        This element is affected by the following invariants: cmp-2
                                                                        TypeReference(Resource)
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                        • profile @ resolve()
                                                                        • 338. Composition.section:plan_of_treatment_section.entry:sliceEntry
                                                                          Slice NamesliceEntry
                                                                          Definition

                                                                          A reference to the actual resource from which the narrative in the section is derived.

                                                                          ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.A reference to data that supports this section
                                                                          Comments

                                                                          If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                          Control0..*
                                                                          This element is affected by the following invariants: cmp-2
                                                                          TypeReference(US Core Goal Profile, US Core MedicationRequest Profile, US Core Encounter Profile, Communication, Appointment, CommunicationRequest, DeviceRequest, NutritionOrder, Task, ServiceRequest, VisionPrescription, RequestGroup, Resource)
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          340. Composition.section:procedures_section
                                                                          Slice Nameprocedures_section
                                                                          Definition

                                                                          The root of the sections that make up the composition.

                                                                          ShortProcedures SectionComposition is broken into sections
                                                                          Comments

                                                                          Procedures Section

                                                                          Control0..1*
                                                                          TypeBackboneElement
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          LabelProcedures Section
                                                                          Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                          342. Composition.section:procedures_section.modifierExtension
                                                                          Definition

                                                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                                          Comments

                                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                          Control0..*
                                                                          TypeExtension
                                                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                          Summarytrue
                                                                          Requirements

                                                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.


                                                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                          Alternate Namesextensions, user content, modifiers
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                          344. Composition.section:procedures_section.title
                                                                          Definition

                                                                          The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                          ShorttitleLabel for section (e.g. for ToC)
                                                                          Comments

                                                                          The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                          Control10..1
                                                                          Typestring
                                                                          Is Modifierfalse
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summaryfalse
                                                                          Requirements

                                                                          Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                          Alternate Namesheader, label, caption
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          346. Composition.section:procedures_section.code
                                                                          Definition

                                                                          A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                          ShortHistory of ProceduresClassification of section (recommended)
                                                                          Comments

                                                                          The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                          If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                          Control10..1
                                                                          BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                                                          (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                          Classification of a section of a composition/document.

                                                                          TypeCodeableConcept
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Requirements

                                                                          Provides computable standardized labels to topics within the document.

                                                                          LabelHistory of Procedures
                                                                          Pattern Value{
                                                                            "coding" : [{
                                                                              "system" : "http://loinc.org",
                                                                              "code" : "47519-4"
                                                                            }]
                                                                          }
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          348. Composition.section:procedures_section.text
                                                                          Definition

                                                                          A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                          ShorttextText summary of the section, for human interpretation
                                                                          Comments

                                                                          Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                          Control10..1
                                                                          This element is affected by the following invariants: cmp-1
                                                                          TypeNarrative
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          350. Composition.section:procedures_section.entry
                                                                          Definition

                                                                          A reference to the actual resource from which the narrative in the section is derived.

                                                                          ShortentryA reference to data that supports this section
                                                                          Comments

                                                                          If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                          Control0..*
                                                                          This element is affected by the following invariants: cmp-2
                                                                          TypeReference(Resource)
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                          • profile @ resolve()
                                                                          • 352. Composition.section:procedures_section.entry:sliceEntry
                                                                            Slice NamesliceEntry
                                                                            Definition

                                                                            A reference to the actual resource from which the narrative in the section is derived.

                                                                            ShortA reference to data that supports this section
                                                                            Comments

                                                                            If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                            Control0..*
                                                                            This element is affected by the following invariants: cmp-2
                                                                            TypeReference(US Core Procedure Profile, Resource)
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            354. Composition.section:reason_for_visit_section
                                                                            Slice Namereason_for_visit_section
                                                                            Definition

                                                                            The root of the sections that make up the composition.

                                                                            ShortReason for Visit SectionComposition is broken into sections
                                                                            Comments

                                                                            Reason for Visit Section

                                                                            Control0..1*
                                                                            TypeBackboneElement
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            LabelReason for Visit Section
                                                                            Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                            356. Composition.section:reason_for_visit_section.modifierExtension
                                                                            Definition

                                                                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                                            Comments

                                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                            Control0..*
                                                                            TypeExtension
                                                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                            Summarytrue
                                                                            Requirements

                                                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.


                                                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                            Alternate Namesextensions, user content, modifiers
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                            358. Composition.section:reason_for_visit_section.title
                                                                            Definition

                                                                            The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                            ShorttitleLabel for section (e.g. for ToC)
                                                                            Comments

                                                                            The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                            Control10..1
                                                                            Typestring
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                            Alternate Namesheader, label, caption
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            360. Composition.section:reason_for_visit_section.code
                                                                            Definition

                                                                            A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                            ShortReason for visitClassification of section (recommended)
                                                                            Comments

                                                                            The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                            If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                            Control10..1
                                                                            BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                                                            (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                            Classification of a section of a composition/document.

                                                                            TypeCodeableConcept
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Provides computable standardized labels to topics within the document.

                                                                            LabelReason for visit
                                                                            Pattern Value{
                                                                              "coding" : [{
                                                                                "system" : "http://loinc.org",
                                                                                "code" : "29299-5"
                                                                              }]
                                                                            }
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            362. Composition.section:reason_for_visit_section.text
                                                                            Definition

                                                                            A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                            ShortThis section contains only human readable contentText summary of the section, for human interpretation
                                                                            Comments

                                                                            Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                            Control10..1
                                                                            This element is affected by the following invariants: cmp-1
                                                                            TypeNarrative
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            364. Composition.section:review_of_systems_section
                                                                            Slice Namereview_of_systems_section
                                                                            Definition

                                                                            The root of the sections that make up the composition.

                                                                            ShortReview of Systems SectionComposition is broken into sections
                                                                            Comments

                                                                            Review of Systems Section

                                                                            Control0..1*
                                                                            TypeBackboneElement
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            LabelReview of Systems Section
                                                                            Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                            366. Composition.section:review_of_systems_section.modifierExtension
                                                                            Definition

                                                                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                                            Comments

                                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                            Control0..*
                                                                            TypeExtension
                                                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                            Summarytrue
                                                                            Requirements

                                                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.


                                                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                            Alternate Namesextensions, user content, modifiers
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                            368. Composition.section:review_of_systems_section.title
                                                                            Definition

                                                                            The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                            ShorttitleLabel for section (e.g. for ToC)
                                                                            Comments

                                                                            The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                            Control10..1
                                                                            Typestring
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                            Alternate Namesheader, label, caption
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            370. Composition.section:review_of_systems_section.code
                                                                            Definition

                                                                            A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                            ShortReview of systemsClassification of section (recommended)
                                                                            Comments

                                                                            The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                            If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                            Control10..1
                                                                            BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                                                            (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                            Classification of a section of a composition/document.

                                                                            TypeCodeableConcept
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Provides computable standardized labels to topics within the document.

                                                                            LabelReview of systems
                                                                            Pattern Value{
                                                                              "coding" : [{
                                                                                "system" : "http://loinc.org",
                                                                                "code" : "10187-3"
                                                                              }]
                                                                            }
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            372. Composition.section:review_of_systems_section.text
                                                                            Definition

                                                                            A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                            ShortThis section contains only human readable contentText summary of the section, for human interpretation
                                                                            Comments

                                                                            Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                            Control10..1
                                                                            This element is affected by the following invariants: cmp-1
                                                                            TypeNarrative
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            374. Composition.section:social_history_section
                                                                            Slice Namesocial_history_section
                                                                            Definition

                                                                            The root of the sections that make up the composition.

                                                                            ShortSocial History SectionComposition is broken into sections
                                                                            Comments

                                                                            Social History Section

                                                                            Control0..1*
                                                                            TypeBackboneElement
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            LabelSocial History Section
                                                                            Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                            376. Composition.section:social_history_section.modifierExtension
                                                                            Definition

                                                                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                                            Comments

                                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                            Control0..*
                                                                            TypeExtension
                                                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                            Summarytrue
                                                                            Requirements

                                                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.


                                                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                            Alternate Namesextensions, user content, modifiers
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                            378. Composition.section:social_history_section.title
                                                                            Definition

                                                                            The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                            ShorttitleLabel for section (e.g. for ToC)
                                                                            Comments

                                                                            The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                            Control10..1
                                                                            Typestring
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                            Alternate Namesheader, label, caption
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            380. Composition.section:social_history_section.code
                                                                            Definition

                                                                            A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                            ShortSocial historyClassification of section (recommended)
                                                                            Comments

                                                                            The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                            If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                            Control10..1
                                                                            BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                                                            (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                            Classification of a section of a composition/document.

                                                                            TypeCodeableConcept
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Provides computable standardized labels to topics within the document.

                                                                            LabelSocial history
                                                                            Pattern Value{
                                                                              "coding" : [{
                                                                                "system" : "http://loinc.org",
                                                                                "code" : "29762-2"
                                                                              }]
                                                                            }
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            382. Composition.section:social_history_section.text
                                                                            Definition

                                                                            A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                            ShorttextText summary of the section, for human interpretation
                                                                            Comments

                                                                            Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                            Control10..1
                                                                            This element is affected by the following invariants: cmp-1
                                                                            TypeNarrative
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            384. Composition.section:social_history_section.entry
                                                                            Definition

                                                                            A reference to the actual resource from which the narrative in the section is derived.

                                                                            ShortentryA reference to data that supports this section
                                                                            Comments

                                                                            If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                            Control0..*
                                                                            This element is affected by the following invariants: cmp-2
                                                                            TypeReference(Resource)
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                            • profile @ resolve()
                                                                            • 386. Composition.section:social_history_section.entry:sliceEntry
                                                                              Slice NamesliceEntry
                                                                              Definition

                                                                              A reference to the actual resource from which the narrative in the section is derived.

                                                                              ShortSmoking statusA reference to data that supports this section
                                                                              Comments

                                                                              If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                              Control0..*
                                                                              This element is affected by the following invariants: cmp-2
                                                                              TypeReference(US Core Smoking Status Observation Profile, Resource)
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              388. Composition.section:vital_signs_section
                                                                              Slice Namevital_signs_section
                                                                              Definition

                                                                              The root of the sections that make up the composition.

                                                                              ShortVital Signs SectionComposition is broken into sections
                                                                              Comments

                                                                              Vital Signs Section

                                                                              Control0..1*
                                                                              TypeBackboneElement
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              LabelVital Signs Section
                                                                              Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                              390. Composition.section:vital_signs_section.modifierExtension
                                                                              Definition

                                                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                                              Comments

                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                              Control0..*
                                                                              TypeExtension
                                                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                              Summarytrue
                                                                              Requirements

                                                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.


                                                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                              Alternate Namesextensions, user content, modifiers
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                              392. Composition.section:vital_signs_section.title
                                                                              Definition

                                                                              The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                              ShorttitleLabel for section (e.g. for ToC)
                                                                              Comments

                                                                              The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                              Control10..1
                                                                              Typestring
                                                                              Is Modifierfalse
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summaryfalse
                                                                              Requirements

                                                                              Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                              Alternate Namesheader, label, caption
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              394. Composition.section:vital_signs_section.code
                                                                              Definition

                                                                              A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                              ShortVital signsClassification of section (recommended)
                                                                              Comments

                                                                              The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                              If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                              Control10..1
                                                                              BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                                                              (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                              Classification of a section of a composition/document.

                                                                              TypeCodeableConcept
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Requirements

                                                                              Provides computable standardized labels to topics within the document.

                                                                              LabelVital signs
                                                                              Pattern Value{
                                                                                "coding" : [{
                                                                                  "system" : "http://loinc.org",
                                                                                  "code" : "8716-3"
                                                                                }]
                                                                              }
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              396. Composition.section:vital_signs_section.text
                                                                              Definition

                                                                              A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                              ShorttextText summary of the section, for human interpretation
                                                                              Comments

                                                                              Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                              Control10..1
                                                                              This element is affected by the following invariants: cmp-1
                                                                              TypeNarrative
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              398. Composition.section:vital_signs_section.entry
                                                                              Definition

                                                                              A reference to the actual resource from which the narrative in the section is derived.

                                                                              ShortentryA reference to data that supports this section
                                                                              Comments

                                                                              If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                              Control0..*
                                                                              This element is affected by the following invariants: cmp-2
                                                                              TypeReference(Resource)
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                              • profile @ resolve()
                                                                              • 400. Composition.section:vital_signs_section.entry:sliceEntry
                                                                                Slice NamesliceEntry
                                                                                Definition

                                                                                A reference to the actual resource from which the narrative in the section is derived.

                                                                                ShortA reference to data that supports this section
                                                                                Comments

                                                                                If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                Control0..*
                                                                                This element is affected by the following invariants: cmp-2
                                                                                TypeReference(Vital Signs Profile, Resource)
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

                                                                                Guidance on how to interpret the contents of this table can be found here

                                                                                0. Composition
                                                                                Definition

                                                                                A set of healthcare-related information that is assembled together into a single logical package that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. A Composition defines the structure and narrative content necessary for a document. However, a Composition alone does not constitute a document. Rather, the Composition must be the first entry in a Bundle where Bundle.type=document, and any other resources referenced from Composition must be included as subsequent entries in the Bundle (for example Patient, Practitioner, Encounter, etc.).

                                                                                ShortA set of resources composed into a single coherent clinical statement with clinical attestation
                                                                                Comments

                                                                                While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical.

                                                                                Control0..*
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                                                                                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 (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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                                                                                dom-6: A resource should have narrative for robust management (text.`div`.exists())
                                                                                2. Composition.id
                                                                                Definition

                                                                                The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

                                                                                ShortLogical id of this artifact
                                                                                Comments

                                                                                The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

                                                                                Control0..1
                                                                                Typeid
                                                                                Is Modifierfalse
                                                                                Summarytrue
                                                                                4. Composition.meta
                                                                                Definition

                                                                                The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

                                                                                ShortMetadata about the resource
                                                                                Control0..1
                                                                                TypeMeta
                                                                                Is Modifierfalse
                                                                                Summarytrue
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                6. Composition.implicitRules
                                                                                Definition

                                                                                A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                                                                                ShortA set of rules under which this content was created
                                                                                Comments

                                                                                Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                                                                                Control0..1
                                                                                Typeuri
                                                                                Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Summarytrue
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                8. Composition.language
                                                                                Definition

                                                                                The base language in which the resource is written.

                                                                                Shortlanguage
                                                                                Comments

                                                                                Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

                                                                                Control1..1
                                                                                BindingThe codes SHOULD be taken from CommonLanguages
                                                                                (preferred to http://hl7.org/fhir/ValueSet/languages)

                                                                                A human language.

                                                                                Additional BindingsPurpose
                                                                                AllLanguagesMax Binding
                                                                                Typecode
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Must Supporttrue
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                10. Composition.text
                                                                                Definition

                                                                                A human-readable narrative that contains a summary of the resource and can 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 "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

                                                                                ShortText summary of the resource, for human interpretation
                                                                                Comments

                                                                                Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

                                                                                Control0..1
                                                                                TypeNarrative
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Alternate Namesnarrative, html, xhtml, display
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                12. Composition.contained
                                                                                Definition

                                                                                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.

                                                                                ShortContained, inline Resources
                                                                                Comments

                                                                                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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

                                                                                Control0..*
                                                                                TypeResource
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Alternate Namesinline resources, anonymous resources, contained resources
                                                                                14. Composition.extension
                                                                                Definition

                                                                                An Extension

                                                                                ShortExtension
                                                                                Control0..*
                                                                                TypeExtension
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                SlicingThis element introduces a set of slices on Composition.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                                • value @ url
                                                                                • 16. Composition.extension:versionNumber
                                                                                  Slice NameversionNumber
                                                                                  Definition

                                                                                  Version specific identifier for the composition, assigned when each version is created/updated.

                                                                                  ShortVersion-specific identifier for composition
                                                                                  Comments

                                                                                  While each resource, including the composition itself, has its own version identifier, this is a formal identifier for the logical version of the composition as a whole. It would remain constant if the resources were moved to a new server, and all got new individual resource versions, for example.

                                                                                  Control0..*
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  TypeExtension(Composition Version Number) (Extension Type: string)
                                                                                  Is Modifierfalse
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  18. Composition.extension:version_number_extension
                                                                                  Slice Nameversion_number_extension
                                                                                  Definition

                                                                                  An Extension

                                                                                  ShortExtension
                                                                                  Control0..1
                                                                                  TypeExtension(Version Number) (Extension Type: integer)
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Summaryfalse
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  20. Composition.extension:data_enterer_extension
                                                                                  Slice Namedata_enterer_extension
                                                                                  Definition

                                                                                  An Extension

                                                                                  ShortExtension
                                                                                  Control0..1
                                                                                  TypeExtension(Data Enterer Extension) (Extension Type: Reference)
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Summaryfalse
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  22. Composition.extension:informant_extension
                                                                                  Slice Nameinformant_extension
                                                                                  Definition

                                                                                  An Extension

                                                                                  Shortinformant
                                                                                  Control0..*
                                                                                  TypeExtension(Informant Extension) (Extension Type: Reference)
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Summaryfalse
                                                                                  Labelinformant
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  24. Composition.extension:information_recipient_extension
                                                                                  Slice Nameinformation_recipient_extension
                                                                                  Definition

                                                                                  An Extension

                                                                                  ShortinformationRecipient
                                                                                  Control0..*
                                                                                  TypeExtension(Information Recipient Extension) (Extension Type: Reference)
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Summaryfalse
                                                                                  LabelinformationRecipient
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  26. Composition.extension:participant_extension
                                                                                  Slice Nameparticipant_extension
                                                                                  Definition

                                                                                  An Extension

                                                                                  Shortparticipant
                                                                                  Control0..*
                                                                                  TypeExtension(Participant Extension) (Extension Type: Reference)
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Summaryfalse
                                                                                  Labelparticipant
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  28. Composition.extension:performer_extension
                                                                                  Slice Nameperformer_extension
                                                                                  Definition

                                                                                  An Extension

                                                                                  Shortperformer
                                                                                  Control0..*
                                                                                  TypeExtension(Performer Extension) (Extension Type: Reference)
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Summaryfalse
                                                                                  Labelperformer
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  30. Composition.extension:authorization_extension
                                                                                  Slice Nameauthorization_extension
                                                                                  Definition

                                                                                  An Extension

                                                                                  Shortauthorization
                                                                                  Control0..*
                                                                                  TypeExtension(Authorization Extension) (Extension Type: Reference)
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Summaryfalse
                                                                                  Labelauthorization
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  32. Composition.extension:order_extension
                                                                                  Slice Nameorder_extension
                                                                                  Definition

                                                                                  An Extension

                                                                                  Shortauthorization
                                                                                  Control0..*
                                                                                  TypeExtension(Order Extension) (Extension Type: Reference)
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Summaryfalse
                                                                                  Labelauthorization
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  34. Composition.modifierExtension
                                                                                  Definition

                                                                                  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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                  ShortExtensions that cannot be ignored
                                                                                  Comments

                                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                  Control0..*
                                                                                  TypeExtension
                                                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                  Alternate Namesextensions, user content
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  36. Composition.identifier
                                                                                  Definition

                                                                                  A version-independent identifier for the Composition. This identifier stays constant as the composition is changed over time.

                                                                                  Shortidentifier
                                                                                  Comments

                                                                                  Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate.

                                                                                  NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                                  Control1..1
                                                                                  TypeIdentifier
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Summarytrue
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  38. Composition.status
                                                                                  Definition

                                                                                  The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.

                                                                                  Shortpreliminary | final | amended | entered-in-error
                                                                                  Comments

                                                                                  If a composition is marked as withdrawn, the compositions/documents in the series, or data from the composition or document series, should never be displayed to a user without being clearly marked as untrustworthy. The flag "entered-in-error" is why this element is labeled as a modifier of other elements.

                                                                                  Some reporting work flows require that the original narrative of a final document never be altered; instead, only new narrative can be added. The composition resource has no explicit status for explicitly noting whether this business rule is in effect. This would be handled by an extension if required.

                                                                                  Control1..1
                                                                                  BindingThe codes SHALL be taken from CompositionStatus
                                                                                  (required to http://hl7.org/fhir/ValueSet/composition-status|4.0.1)

                                                                                  The workflow/clinical status of the composition.

                                                                                  Typecode
                                                                                  Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Need to be able to mark interim, amended, or withdrawn compositions or documents.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  40. Composition.type
                                                                                  Definition

                                                                                  Specifies the particular kind of composition (e.g. History and Physical, Discharge Summary, Progress Note). This usually equates to the purpose of making the composition.

                                                                                  ShortConsultation Note
                                                                                  Comments

                                                                                  For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation guides will require a specific LOINC code, or use LOINC as an extensible binding.

                                                                                  Control1..1
                                                                                  BindingThe codes SHALL be taken from ConsultDocumentType
                                                                                  (required to http://hl7.org/fhir/us/ccda/ValueSet/2.16.840.1.113883.11.20.9.31)
                                                                                  TypeCodeableConcept
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Key metadata element describing the composition, used in searching/filtering.

                                                                                  LabelConsultation Note
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  42. Composition.category
                                                                                  Definition

                                                                                  A categorization for the type of the composition - helps for indexing and searching. This may be implied by or derived from the code specified in the Composition Type.

                                                                                  ShortCategorization of Composition
                                                                                  Comments

                                                                                  This is a metadata field from XDS/MHD.

                                                                                  Control0..*
                                                                                  BindingFor example codes, see DocumentClassValueSet
                                                                                  (example to http://hl7.org/fhir/ValueSet/document-classcodes)

                                                                                  High-level kind of a clinical document at a macro level.

                                                                                  TypeCodeableConcept
                                                                                  Is Modifierfalse
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Helps humans to assess whether the composition is of interest when viewing an index of compositions or documents.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  44. Composition.subject
                                                                                  Definition

                                                                                  Who or what the composition is about. The composition can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure).

                                                                                  ShortWho and/or what the composition is about
                                                                                  Comments

                                                                                  For clinical documents, this is usually the patient.

                                                                                  Control0..1
                                                                                  TypeReference(US Core Patient Profile, Group)
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Must Support TypesNo must-support rules about the choice of types/profiles
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Essential metadata for searching for the composition. Identifies who and/or what the composition/document is about.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  46. Composition.encounter
                                                                                  Definition

                                                                                  Describes the clinical encounter or type of care this documentation is associated with.

                                                                                  ShortencompassingEncounter
                                                                                  Control1..1
                                                                                  TypeReference(US Core Encounter Profile)
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Provides context for the composition and supports searching.

                                                                                  LabelencompassingEncounter
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  48. Composition.date
                                                                                  Definition

                                                                                  The composition editing time, when the composition was last logically changed by the author.

                                                                                  Shortdate
                                                                                  Comments

                                                                                  The Last Modified Date on the composition may be after the date of the document was attested without being changed.

                                                                                  Control1..1
                                                                                  TypedateTime
                                                                                  Is Modifierfalse
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Must Supporttrue
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring. When packaged in a document, Bundle.timestamp is the date of packaging.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  50. Composition.author
                                                                                  Definition

                                                                                  Identifies who is responsible for the information in the composition, not necessarily who typed it in.

                                                                                  ShortWho and/or what authored the composition
                                                                                  Control1..*
                                                                                  TypeReference(US Core Practitioner Profile, US Core PractitionerRole Profile, PractitionerRole, US Core Patient Profile, Device, RelatedPerson)
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Must Support TypesNo must-support rules about the choice of types/profiles
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Identifies who is responsible for the content.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  52. Composition.title
                                                                                  Definition

                                                                                  Official human-readable label for the composition.

                                                                                  ShortDocument Title
                                                                                  Comments

                                                                                  For many compositions, the title is the same as the text or a display name of Composition.type (e.g. a "consultation" or "progress note"). Note that CDA does not make title mandatory, but there are no known cases where it is useful for title to be omitted, so it is mandatory here. Feedback on this requirement is welcome during the trial use period.

                                                                                  Control1..1
                                                                                  Typestring
                                                                                  Is Modifierfalse
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Must Supporttrue
                                                                                  Summarytrue
                                                                                  LabelDocument Title
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  54. Composition.confidentiality
                                                                                  Definition

                                                                                  Use the confidentiality codes in Meta.security (https://hl7.org/fhir/security-labels.html)

                                                                                  ShortUse the confidentiality codes in Meta.security
                                                                                  Comments

                                                                                  The exact use of this element, and enforcement and issues related to highly sensitive documents are out of scope for the base specification, and delegated to implementation profiles (see security section). This element is labeled as a modifier because highly confidential documents must not be treated as if they are not.

                                                                                  Control0..0
                                                                                  BindingThe codes SHALL be taken from v3.ConfidentialityClassification (2014-03-26)
                                                                                  (required to http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26)

                                                                                  Codes specifying the level of confidentiality of the composition.

                                                                                  Typecode
                                                                                  Is Modifierfalse
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Must Supportfalse
                                                                                  Summarytrue
                                                                                  LabelUse the confidentiality codes in Meta.security
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  56. Composition.attester
                                                                                  Definition

                                                                                  A participant who has attested to the accuracy of the composition/document.

                                                                                  ShortAttests to accuracy of composition
                                                                                  Comments

                                                                                  Only list each attester once.

                                                                                  Control0..*
                                                                                  TypeBackboneElement
                                                                                  Is Modifierfalse
                                                                                  Must Supportfalse
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  Identifies responsibility for the accuracy of the composition content.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  SlicingThis element introduces a set of slices on Composition.attester. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                                  • value @ mode
                                                                                  • 58. Composition.attester.id
                                                                                    Definition

                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                    ShortUnique id for inter-element referencing
                                                                                    Control0..1
                                                                                    Typestring
                                                                                    Is Modifierfalse
                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                    Summaryfalse
                                                                                    60. Composition.attester.extension
                                                                                    Definition

                                                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                    ShortAdditional content defined by implementations
                                                                                    Comments

                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                    Control0..*
                                                                                    TypeExtension
                                                                                    Is Modifierfalse
                                                                                    Summaryfalse
                                                                                    Alternate Namesextensions, user content
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                    62. Composition.attester.modifierExtension
                                                                                    Definition

                                                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                                    Comments

                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                    Control0..*
                                                                                    TypeExtension
                                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                    Alternate Namesextensions, user content, modifiers
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                    64. Composition.attester.mode
                                                                                    Definition

                                                                                    The type of attestation the authenticator offers.

                                                                                    Shortpersonal | professional | legal | official
                                                                                    Control1..1
                                                                                    BindingThe codes SHALL be taken from CompositionAttestationMode
                                                                                    (required to http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1)

                                                                                    The way in which a person authenticated a composition.

                                                                                    Typecode
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summaryfalse
                                                                                    Requirements

                                                                                    Indicates the level of authority of the attestation.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    66. Composition.attester.time
                                                                                    Definition

                                                                                    When the composition was attested by the party.

                                                                                    ShortWhen the composition was attested
                                                                                    Control0..1
                                                                                    TypedateTime
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summaryfalse
                                                                                    Requirements

                                                                                    Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    68. Composition.attester.party
                                                                                    Definition

                                                                                    Who attested the composition in the specified way.

                                                                                    ShortWho attested the composition
                                                                                    Control0..1
                                                                                    TypeReference(Patient, RelatedPerson, Practitioner, PractitionerRole, Organization)
                                                                                    Is Modifierfalse
                                                                                    Summaryfalse
                                                                                    Requirements

                                                                                    Identifies who has taken on the responsibility for accuracy of the composition content.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    70. Composition.attester:legal_attester
                                                                                    Slice Namelegal_attester
                                                                                    Definition

                                                                                    A participant who has attested to the accuracy of the composition/document.

                                                                                    Shortattester
                                                                                    Comments

                                                                                    Only list each attester once.

                                                                                    Control0..1
                                                                                    TypeBackboneElement
                                                                                    Is Modifierfalse
                                                                                    Must Supporttrue
                                                                                    Summaryfalse
                                                                                    Requirements

                                                                                    Identifies responsibility for the accuracy of the composition content.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    72. Composition.attester:legal_attester.id
                                                                                    Definition

                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                    ShortUnique id for inter-element referencing
                                                                                    Control0..1
                                                                                    Typestring
                                                                                    Is Modifierfalse
                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                    Summaryfalse
                                                                                    74. Composition.attester:legal_attester.extension
                                                                                    Definition

                                                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                    ShortAdditional content defined by implementations
                                                                                    Comments

                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                    Control0..*
                                                                                    TypeExtension
                                                                                    Is Modifierfalse
                                                                                    Summaryfalse
                                                                                    Alternate Namesextensions, user content
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                    76. Composition.attester:legal_attester.modifierExtension
                                                                                    Definition

                                                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                                    Comments

                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                    Control0..*
                                                                                    TypeExtension
                                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                    Alternate Namesextensions, user content, modifiers
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                    78. Composition.attester:legal_attester.mode
                                                                                    Definition

                                                                                    The type of attestation the authenticator offers.

                                                                                    Shortmode
                                                                                    Control1..1
                                                                                    BindingThe codes SHALL be taken from CompositionAttestationMode
                                                                                    (required to http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1)

                                                                                    The way in which a person authenticated a composition.

                                                                                    Typecode
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Must Supporttrue
                                                                                    Summaryfalse
                                                                                    Requirements

                                                                                    Indicates the level of authority of the attestation.

                                                                                    Fixed Valuelegal
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    80. Composition.attester:legal_attester.time
                                                                                    Definition

                                                                                    When the composition was attested by the party.

                                                                                    ShortWhen the composition was attested
                                                                                    Control0..1
                                                                                    TypedateTime
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summaryfalse
                                                                                    Requirements

                                                                                    Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    82. Composition.attester:legal_attester.party
                                                                                    Definition

                                                                                    Who attested the composition in the specified way.

                                                                                    Shortparty
                                                                                    Control1..1
                                                                                    TypeReference(US Core Practitioner Profile, US Core PractitionerRole Profile)
                                                                                    Is Modifierfalse
                                                                                    Must Supporttrue
                                                                                    Must Support TypesNo must-support rules about the choice of types/profiles
                                                                                    Summaryfalse
                                                                                    Requirements

                                                                                    Identifies who has taken on the responsibility for accuracy of the composition content.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    84. Composition.attester:professional_attester
                                                                                    Slice Nameprofessional_attester
                                                                                    Definition

                                                                                    A participant who has attested to the accuracy of the composition/document.

                                                                                    Shortattester
                                                                                    Comments

                                                                                    Only list each attester once.

                                                                                    Control0..*
                                                                                    TypeBackboneElement
                                                                                    Is Modifierfalse
                                                                                    Must Supporttrue
                                                                                    Summaryfalse
                                                                                    Requirements

                                                                                    Identifies responsibility for the accuracy of the composition content.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    86. Composition.attester:professional_attester.id
                                                                                    Definition

                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                    ShortUnique id for inter-element referencing
                                                                                    Control0..1
                                                                                    Typestring
                                                                                    Is Modifierfalse
                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                    Summaryfalse
                                                                                    88. Composition.attester:professional_attester.extension
                                                                                    Definition

                                                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                    ShortAdditional content defined by implementations
                                                                                    Comments

                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                    Control0..*
                                                                                    TypeExtension
                                                                                    Is Modifierfalse
                                                                                    Summaryfalse
                                                                                    Alternate Namesextensions, user content
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                    90. Composition.attester:professional_attester.modifierExtension
                                                                                    Definition

                                                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                                    Comments

                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                    Control0..*
                                                                                    TypeExtension
                                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                    Alternate Namesextensions, user content, modifiers
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                    92. Composition.attester:professional_attester.mode
                                                                                    Definition

                                                                                    The type of attestation the authenticator offers.

                                                                                    Shortmode
                                                                                    Control1..1
                                                                                    BindingThe codes SHALL be taken from CompositionAttestationMode
                                                                                    (required to http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1)

                                                                                    The way in which a person authenticated a composition.

                                                                                    Typecode
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Must Supporttrue
                                                                                    Summaryfalse
                                                                                    Requirements

                                                                                    Indicates the level of authority of the attestation.

                                                                                    Fixed Valueprofessional
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    94. Composition.attester:professional_attester.time
                                                                                    Definition

                                                                                    When the composition was attested by the party.

                                                                                    ShortWhen the composition was attested
                                                                                    Control0..1
                                                                                    TypedateTime
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summaryfalse
                                                                                    Requirements

                                                                                    Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    96. Composition.attester:professional_attester.party
                                                                                    Definition

                                                                                    Who attested the composition in the specified way.

                                                                                    Shortparty
                                                                                    Control1..1
                                                                                    TypeReference(US Core Practitioner Profile, US Core PractitionerRole Profile)
                                                                                    Is Modifierfalse
                                                                                    Must Supporttrue
                                                                                    Must Support TypesNo must-support rules about the choice of types/profiles
                                                                                    Summaryfalse
                                                                                    Requirements

                                                                                    Identifies who has taken on the responsibility for accuracy of the composition content.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    98. Composition.attester:personal_attester
                                                                                    Slice Namepersonal_attester
                                                                                    Definition

                                                                                    A participant who has attested to the accuracy of the composition/document.

                                                                                    Shortattester
                                                                                    Comments

                                                                                    Only list each attester once.

                                                                                    Control0..*
                                                                                    TypeBackboneElement
                                                                                    Is Modifierfalse
                                                                                    Must Supporttrue
                                                                                    Summaryfalse
                                                                                    Requirements

                                                                                    Identifies responsibility for the accuracy of the composition content.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    100. Composition.attester:personal_attester.id
                                                                                    Definition

                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                    ShortUnique id for inter-element referencing
                                                                                    Control0..1
                                                                                    Typestring
                                                                                    Is Modifierfalse
                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                    Summaryfalse
                                                                                    102. Composition.attester:personal_attester.extension
                                                                                    Definition

                                                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                    ShortAdditional content defined by implementations
                                                                                    Comments

                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                    Control0..*
                                                                                    TypeExtension
                                                                                    Is Modifierfalse
                                                                                    Summaryfalse
                                                                                    Alternate Namesextensions, user content
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                    104. Composition.attester:personal_attester.modifierExtension
                                                                                    Definition

                                                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                                    Comments

                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                    Control0..*
                                                                                    TypeExtension
                                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                    Alternate Namesextensions, user content, modifiers
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                    106. Composition.attester:personal_attester.mode
                                                                                    Definition

                                                                                    The type of attestation the authenticator offers.

                                                                                    Shortmode
                                                                                    Control1..1
                                                                                    BindingThe codes SHALL be taken from CompositionAttestationMode
                                                                                    (required to http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1)

                                                                                    The way in which a person authenticated a composition.

                                                                                    Typecode
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Must Supporttrue
                                                                                    Summaryfalse
                                                                                    Requirements

                                                                                    Indicates the level of authority of the attestation.

                                                                                    Fixed Valuepersonal
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    108. Composition.attester:personal_attester.time
                                                                                    Definition

                                                                                    When the composition was attested by the party.

                                                                                    ShortWhen the composition was attested
                                                                                    Control0..1
                                                                                    TypedateTime
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summaryfalse
                                                                                    Requirements

                                                                                    Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    110. Composition.attester:personal_attester.party
                                                                                    Definition

                                                                                    Who attested the composition in the specified way.

                                                                                    Shortparty
                                                                                    Control1..1
                                                                                    TypeReference(US Core Patient Profile, RelatedPerson)
                                                                                    Is Modifierfalse
                                                                                    Must Supporttrue
                                                                                    Must Support TypesNo must-support rules about the choice of types/profiles
                                                                                    Summaryfalse
                                                                                    Requirements

                                                                                    Identifies who has taken on the responsibility for accuracy of the composition content.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    112. Composition.custodian
                                                                                    Definition

                                                                                    Identifies the organization or group who is responsible for ongoing maintenance of and access to the composition/document information.

                                                                                    Shortcustodian
                                                                                    Comments

                                                                                    This is useful when documents are derived from a composition - provides guidance for how to get the latest version of the document. This is optional because this is sometimes not known by the authoring system, and can be inferred by context. However, it is important that this information be known when working with a derived document, so providing a custodian is encouraged.

                                                                                    Control1..1
                                                                                    TypeReference(US Core Organization Profile)
                                                                                    Is Modifierfalse
                                                                                    Must Supporttrue
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    Identifies where to go to find the current version, where to report issues, etc.

                                                                                    Labelcustodian
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    114. Composition.relatesTo
                                                                                    Definition

                                                                                    Relationships that this composition has with other compositions or documents that already exist.

                                                                                    ShortRelationships to other compositions/documents
                                                                                    Comments

                                                                                    A document is a version specific composition.

                                                                                    Control0..*
                                                                                    TypeBackboneElement
                                                                                    Is Modifierfalse
                                                                                    Summaryfalse
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    116. Composition.relatesTo.id
                                                                                    Definition

                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                    ShortUnique id for inter-element referencing
                                                                                    Control0..1
                                                                                    Typestring
                                                                                    Is Modifierfalse
                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                    Summaryfalse
                                                                                    118. Composition.relatesTo.extension
                                                                                    Definition

                                                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                    ShortAdditional content defined by implementations
                                                                                    Comments

                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                    Control0..*
                                                                                    TypeExtension
                                                                                    Is Modifierfalse
                                                                                    Summaryfalse
                                                                                    Alternate Namesextensions, user content
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                    120. Composition.relatesTo.modifierExtension
                                                                                    Definition

                                                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                                    Comments

                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                    Control0..*
                                                                                    TypeExtension
                                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                    Alternate Namesextensions, user content, modifiers
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                    122. Composition.relatesTo.code
                                                                                    Definition

                                                                                    The type of relationship that this composition has with anther composition or document.

                                                                                    Shortreplaces | transforms | signs | appends
                                                                                    Comments

                                                                                    If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.

                                                                                    Control1..1
                                                                                    BindingThe codes SHALL be taken from DocumentRelationshipType
                                                                                    (required to http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1)

                                                                                    The type of relationship between documents.

                                                                                    Typecode
                                                                                    Is Modifierfalse
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Summaryfalse
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    124. Composition.relatesTo.target[x]
                                                                                    Definition

                                                                                    The target composition/document of this relationship.

                                                                                    ShortTarget of the relationship
                                                                                    Control1..1
                                                                                    TypeChoice of: Identifier, Reference(Composition)
                                                                                    [x] NoteSee Choice of Data Types for further information about how to use [x]
                                                                                    Is Modifierfalse
                                                                                    Summaryfalse
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    126. Composition.event
                                                                                    Definition

                                                                                    The clinical service, such as a colonoscopy or an appendectomy, being documented.

                                                                                    ShortThe clinical service(s) being documented
                                                                                    Comments

                                                                                    The event needs to be consistent with the type element, though can provide further information if desired.

                                                                                    Control0..*
                                                                                    TypeBackboneElement
                                                                                    Is Modifierfalse
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    128. Composition.event.id
                                                                                    Definition

                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                    ShortUnique id for inter-element referencing
                                                                                    Control0..1
                                                                                    Typestring
                                                                                    Is Modifierfalse
                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                    Summaryfalse
                                                                                    130. Composition.event.extension
                                                                                    Definition

                                                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                    ShortAdditional content defined by implementations
                                                                                    Comments

                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                    Control0..*
                                                                                    TypeExtension
                                                                                    Is Modifierfalse
                                                                                    Summaryfalse
                                                                                    Alternate Namesextensions, user content
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                    132. Composition.event.modifierExtension
                                                                                    Definition

                                                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                                    Comments

                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                    Control0..*
                                                                                    TypeExtension
                                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                    Alternate Namesextensions, user content, modifiers
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                    134. Composition.event.code
                                                                                    Definition

                                                                                    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 "History and Physical Report" in which the procedure being documented is necessarily a "History and Physical" act.

                                                                                    ShortCode(s) that apply to the event being documented
                                                                                    Comments

                                                                                    An event can further specialize the act inherent in the typeCode, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more eventCodes are included, they SHALL NOT conflict with the values inherent in the classCode, practiceSettingCode or typeCode, as such a conflict would create an ambiguous situation. This short list of codes is provided to be used as key words for certain types of queries.

                                                                                    Control0..*
                                                                                    BindingFor example codes, see v3 Code System ActCode
                                                                                    (example to http://terminology.hl7.org/ValueSet/v3-ActCode)

                                                                                    This list of codes represents the main clinical acts being documented.

                                                                                    TypeCodeableConcept
                                                                                    Is Modifierfalse
                                                                                    Summarytrue
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    136. Composition.event.period
                                                                                    Definition

                                                                                    The period of time covered by the documentation. There is no assertion that the documentation is a complete representation for this period, only that it documents events during this time.

                                                                                    ShortThe period covered by the documentation
                                                                                    Control0..1
                                                                                    TypePeriod
                                                                                    Is Modifierfalse
                                                                                    Summarytrue
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    138. Composition.event.detail
                                                                                    Definition

                                                                                    The description and/or reference of the event(s) being documented. For example, this could be used to document such a colonoscopy or an appendectomy.

                                                                                    ShortThe event(s) being documented
                                                                                    Control0..*
                                                                                    TypeReference(Resource)
                                                                                    Is Modifierfalse
                                                                                    Summarytrue
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    140. Composition.section
                                                                                    Definition

                                                                                    The root of the sections that make up the composition.

                                                                                    ShortComposition is broken into sections
                                                                                    Control0..*
                                                                                    TypeBackboneElement
                                                                                    Is Modifierfalse
                                                                                    Summaryfalse
                                                                                    Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    SlicingThis element introduces a set of slices on Composition.section. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                                    • value @ code
                                                                                    • 142. Composition.section.id
                                                                                      Definition

                                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                      ShortUnique id for inter-element referencing
                                                                                      Control0..1
                                                                                      Typestring
                                                                                      Is Modifierfalse
                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                      Summaryfalse
                                                                                      144. Composition.section.extension
                                                                                      Definition

                                                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                      ShortAdditional content defined by implementations
                                                                                      Comments

                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                      Control0..*
                                                                                      TypeExtension
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Alternate Namesextensions, user content
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                      146. Composition.section.modifierExtension
                                                                                      Definition

                                                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                                                      Comments

                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                      Control0..*
                                                                                      TypeExtension
                                                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                      Summarytrue
                                                                                      Requirements

                                                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                      Alternate Namesextensions, user content, modifiers
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                      148. Composition.section.title
                                                                                      Definition

                                                                                      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                      ShortLabel for section (e.g. for ToC)
                                                                                      Comments

                                                                                      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                      Control0..1
                                                                                      Typestring
                                                                                      Is Modifierfalse
                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                      Alternate Namesheader, label, caption
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      150. Composition.section.code
                                                                                      Definition

                                                                                      A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                      ShortClassification of section (recommended)
                                                                                      Comments

                                                                                      The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                      Control0..1
                                                                                      BindingFor example codes, see DocumentSectionCodes
                                                                                      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                      Classification of a section of a composition/document.

                                                                                      TypeCodeableConcept
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      Provides computable standardized labels to topics within the document.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      152. Composition.section.author
                                                                                      Definition

                                                                                      Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                      ShortWho and/or what authored the section
                                                                                      Control0..*
                                                                                      TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      Identifies who is responsible for the content.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      154. Composition.section.focus
                                                                                      Definition

                                                                                      The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                      ShortWho/what the section is about, when it is not about the subject of composition
                                                                                      Comments

                                                                                      Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                      Control0..1
                                                                                      TypeReference(Resource)
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      156. Composition.section.text
                                                                                      Definition

                                                                                      A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                                      ShortText summary of the section, for human interpretation
                                                                                      Comments

                                                                                      Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                      Control0..1
                                                                                      This element is affected by the following invariants: cmp-1
                                                                                      TypeNarrative
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      158. Composition.section.mode
                                                                                      Definition

                                                                                      How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                      Shortworking | snapshot | changes
                                                                                      Comments

                                                                                      This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                      Control0..1
                                                                                      BindingThe codes SHALL be taken from ListMode
                                                                                      (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                      The processing mode that applies to this section.

                                                                                      Typecode
                                                                                      Is Modifierfalse
                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      160. Composition.section.orderedBy
                                                                                      Definition

                                                                                      Specifies the order applied to the items in the section entries.

                                                                                      ShortOrder of section entries
                                                                                      Comments

                                                                                      Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                      Control0..1
                                                                                      BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                      (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                      What order applies to the items in the entry.

                                                                                      TypeCodeableConcept
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      162. Composition.section.entry
                                                                                      Definition

                                                                                      A reference to the actual resource from which the narrative in the section is derived.

                                                                                      ShortA reference to data that supports this section
                                                                                      Comments

                                                                                      If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                      Control0..*
                                                                                      This element is affected by the following invariants: cmp-2
                                                                                      TypeReference(Resource)
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      164. Composition.section.emptyReason
                                                                                      Definition

                                                                                      If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                      ShortWhy the section is empty
                                                                                      Comments

                                                                                      The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                      Control0..1
                                                                                      This element is affected by the following invariants: cmp-2
                                                                                      BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                      (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                                      If a section is empty, why it is empty.

                                                                                      TypeCodeableConcept
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      166. Composition.section.section
                                                                                      Definition

                                                                                      A nested sub-section within this section.

                                                                                      ShortNested Section
                                                                                      Comments

                                                                                      Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                      Control0..*
                                                                                      This element is affected by the following invariants: cmp-1
                                                                                      TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      168. Composition.section:allergies_and_intolerances_section
                                                                                      Slice Nameallergies_and_intolerances_section
                                                                                      Definition

                                                                                      The root of the sections that make up the composition.

                                                                                      ShortAllergies and Intolerances Section
                                                                                      Comments

                                                                                      Allergies and Intolerances Section

                                                                                      Control1..1
                                                                                      TypeBackboneElement
                                                                                      Is Modifierfalse
                                                                                      Must Supporttrue
                                                                                      Summaryfalse
                                                                                      LabelAllergies and Intolerances Section
                                                                                      Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      170. Composition.section:allergies_and_intolerances_section.id
                                                                                      Definition

                                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                      ShortUnique id for inter-element referencing
                                                                                      Control0..1
                                                                                      Typestring
                                                                                      Is Modifierfalse
                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                      Summaryfalse
                                                                                      172. Composition.section:allergies_and_intolerances_section.extension
                                                                                      Definition

                                                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                      ShortAdditional content defined by implementations
                                                                                      Comments

                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                      Control0..*
                                                                                      TypeExtension
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Alternate Namesextensions, user content
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                      174. Composition.section:allergies_and_intolerances_section.modifierExtension
                                                                                      Definition

                                                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                                                      Comments

                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                      Control0..*
                                                                                      TypeExtension
                                                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                      Summarytrue
                                                                                      Requirements

                                                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                      Alternate Namesextensions, user content, modifiers
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                      176. Composition.section:allergies_and_intolerances_section.title
                                                                                      Definition

                                                                                      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                      Shorttitle
                                                                                      Comments

                                                                                      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                      Control1..1
                                                                                      Typestring
                                                                                      Is Modifierfalse
                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                      Must Supporttrue
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                      Alternate Namesheader, label, caption
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      178. Composition.section:allergies_and_intolerances_section.code
                                                                                      Definition

                                                                                      A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                      ShortAllergies and adverse reactions
                                                                                      Comments

                                                                                      The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                      Control1..1
                                                                                      BindingFor example codes, see DocumentSectionCodes
                                                                                      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                      Classification of a section of a composition/document.

                                                                                      TypeCodeableConcept
                                                                                      Is Modifierfalse
                                                                                      Must Supporttrue
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      Provides computable standardized labels to topics within the document.

                                                                                      LabelAllergies and adverse reactions
                                                                                      Pattern Value{
                                                                                        "coding" : [{
                                                                                          "system" : "http://loinc.org",
                                                                                          "code" : "48765-2"
                                                                                        }]
                                                                                      }
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      180. Composition.section:allergies_and_intolerances_section.author
                                                                                      Definition

                                                                                      Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                      ShortWho and/or what authored the section
                                                                                      Control0..*
                                                                                      TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      Identifies who is responsible for the content.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      182. Composition.section:allergies_and_intolerances_section.focus
                                                                                      Definition

                                                                                      The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                      ShortWho/what the section is about, when it is not about the subject of composition
                                                                                      Comments

                                                                                      Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                      Control0..1
                                                                                      TypeReference(Resource)
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      184. Composition.section:allergies_and_intolerances_section.text
                                                                                      Definition

                                                                                      A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                                      Shorttext
                                                                                      Comments

                                                                                      Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                      Control1..1
                                                                                      This element is affected by the following invariants: cmp-1
                                                                                      TypeNarrative
                                                                                      Is Modifierfalse
                                                                                      Must Supporttrue
                                                                                      Summaryfalse
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      186. Composition.section:allergies_and_intolerances_section.mode
                                                                                      Definition

                                                                                      How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                      Shortworking | snapshot | changes
                                                                                      Comments

                                                                                      This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                      Control0..1
                                                                                      BindingThe codes SHALL be taken from ListMode
                                                                                      (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                      The processing mode that applies to this section.

                                                                                      Typecode
                                                                                      Is Modifierfalse
                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      188. Composition.section:allergies_and_intolerances_section.orderedBy
                                                                                      Definition

                                                                                      Specifies the order applied to the items in the section entries.

                                                                                      ShortOrder of section entries
                                                                                      Comments

                                                                                      Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                      Control0..1
                                                                                      BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                      (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                      What order applies to the items in the entry.

                                                                                      TypeCodeableConcept
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Requirements

                                                                                      Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      190. Composition.section:allergies_and_intolerances_section.entry
                                                                                      Definition

                                                                                      A reference to the actual resource from which the narrative in the section is derived.

                                                                                      Shortentry
                                                                                      Comments

                                                                                      If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                      Control0..*
                                                                                      This element is affected by the following invariants: cmp-2
                                                                                      TypeReference(Resource)
                                                                                      Is Modifierfalse
                                                                                      Summaryfalse
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                                      • profile @ resolve()
                                                                                      • 192. Composition.section:allergies_and_intolerances_section.entry:allergy_intolerance_entry
                                                                                        Slice Nameallergy_intolerance_entry
                                                                                        Definition

                                                                                        A reference to the actual resource from which the narrative in the section is derived.

                                                                                        ShortA reference to data that supports this section
                                                                                        Comments

                                                                                        If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                        Control0..*
                                                                                        This element is affected by the following invariants: cmp-2
                                                                                        TypeReference(US Core AllergyIntolerance Profile)
                                                                                        Is Modifierfalse
                                                                                        Must Supporttrue
                                                                                        Summaryfalse
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        194. Composition.section:allergies_and_intolerances_section.emptyReason
                                                                                        Definition

                                                                                        If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                        ShortWhy the section is empty
                                                                                        Comments

                                                                                        The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                        Control0..1
                                                                                        This element is affected by the following invariants: cmp-2
                                                                                        BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                        (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                                        If a section is empty, why it is empty.

                                                                                        TypeCodeableConcept
                                                                                        Is Modifierfalse
                                                                                        Summaryfalse
                                                                                        Requirements

                                                                                        Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        196. Composition.section:allergies_and_intolerances_section.section
                                                                                        Definition

                                                                                        A nested sub-section within this section.

                                                                                        ShortNested Section
                                                                                        Comments

                                                                                        Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                        Control0..*
                                                                                        This element is affected by the following invariants: cmp-1
                                                                                        TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                        Is Modifierfalse
                                                                                        Summaryfalse
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        198. Composition.section:history_of_present_illness_section
                                                                                        Slice Namehistory_of_present_illness_section
                                                                                        Definition

                                                                                        The root of the sections that make up the composition.

                                                                                        ShortHistory of Present Illness Section
                                                                                        Comments

                                                                                        History of Present Illness Section

                                                                                        Control1..1
                                                                                        TypeBackboneElement
                                                                                        Is Modifierfalse
                                                                                        Must Supporttrue
                                                                                        Summaryfalse
                                                                                        LabelHistory of Present Illness Section
                                                                                        Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                        cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        200. Composition.section:history_of_present_illness_section.id
                                                                                        Definition

                                                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                        ShortUnique id for inter-element referencing
                                                                                        Control0..1
                                                                                        Typestring
                                                                                        Is Modifierfalse
                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                        Summaryfalse
                                                                                        202. Composition.section:history_of_present_illness_section.extension
                                                                                        Definition

                                                                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                        ShortAdditional content defined by implementations
                                                                                        Comments

                                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                        Control0..*
                                                                                        TypeExtension
                                                                                        Is Modifierfalse
                                                                                        Summaryfalse
                                                                                        Alternate Namesextensions, user content
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                        204. Composition.section:history_of_present_illness_section.modifierExtension
                                                                                        Definition

                                                                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                                                        Comments

                                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                        Control0..*
                                                                                        TypeExtension
                                                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                        Summarytrue
                                                                                        Requirements

                                                                                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                        Alternate Namesextensions, user content, modifiers
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                        206. Composition.section:history_of_present_illness_section.title
                                                                                        Definition

                                                                                        The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                        Shorttitle
                                                                                        Comments

                                                                                        The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                        Control1..1
                                                                                        Typestring
                                                                                        Is Modifierfalse
                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                        Must Supporttrue
                                                                                        Summaryfalse
                                                                                        Requirements

                                                                                        Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                        Alternate Namesheader, label, caption
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        208. Composition.section:history_of_present_illness_section.code
                                                                                        Definition

                                                                                        A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                        ShortHistory of present illness
                                                                                        Comments

                                                                                        The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                        If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                        Control1..1
                                                                                        BindingFor example codes, see DocumentSectionCodes
                                                                                        (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                        Classification of a section of a composition/document.

                                                                                        TypeCodeableConcept
                                                                                        Is Modifierfalse
                                                                                        Must Supporttrue
                                                                                        Summaryfalse
                                                                                        Requirements

                                                                                        Provides computable standardized labels to topics within the document.

                                                                                        LabelHistory of present illness
                                                                                        Pattern Value{
                                                                                          "coding" : [{
                                                                                            "system" : "http://loinc.org",
                                                                                            "code" : "10164-2"
                                                                                          }]
                                                                                        }
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        210. Composition.section:history_of_present_illness_section.author
                                                                                        Definition

                                                                                        Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                        ShortWho and/or what authored the section
                                                                                        Control0..*
                                                                                        TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                        Is Modifierfalse
                                                                                        Summaryfalse
                                                                                        Requirements

                                                                                        Identifies who is responsible for the content.

                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        212. Composition.section:history_of_present_illness_section.focus
                                                                                        Definition

                                                                                        The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                        ShortWho/what the section is about, when it is not about the subject of composition
                                                                                        Comments

                                                                                        Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                        Control0..1
                                                                                        TypeReference(Resource)
                                                                                        Is Modifierfalse
                                                                                        Summaryfalse
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        214. Composition.section:history_of_present_illness_section.text
                                                                                        Definition

                                                                                        A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                                        ShortThis section contains only human readable content
                                                                                        Comments

                                                                                        Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                        Control1..1
                                                                                        This element is affected by the following invariants: cmp-1
                                                                                        TypeNarrative
                                                                                        Is Modifierfalse
                                                                                        Must Supporttrue
                                                                                        Summaryfalse
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        216. Composition.section:history_of_present_illness_section.mode
                                                                                        Definition

                                                                                        How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                        Shortworking | snapshot | changes
                                                                                        Comments

                                                                                        This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                        Control0..1
                                                                                        BindingThe codes SHALL be taken from ListMode
                                                                                        (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                        The processing mode that applies to this section.

                                                                                        Typecode
                                                                                        Is Modifierfalse
                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                        Summaryfalse
                                                                                        Requirements

                                                                                        Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        218. Composition.section:history_of_present_illness_section.orderedBy
                                                                                        Definition

                                                                                        Specifies the order applied to the items in the section entries.

                                                                                        ShortOrder of section entries
                                                                                        Comments

                                                                                        Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                        Control0..1
                                                                                        BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                        (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                        What order applies to the items in the entry.

                                                                                        TypeCodeableConcept
                                                                                        Is Modifierfalse
                                                                                        Summaryfalse
                                                                                        Requirements

                                                                                        Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        220. Composition.section:history_of_present_illness_section.entry
                                                                                        Definition

                                                                                        A reference to the actual resource from which the narrative in the section is derived.

                                                                                        ShortA reference to data that supports this section
                                                                                        Comments

                                                                                        If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                        Control0..*
                                                                                        This element is affected by the following invariants: cmp-2
                                                                                        TypeReference(Resource)
                                                                                        Is Modifierfalse
                                                                                        Summaryfalse
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        222. Composition.section:history_of_present_illness_section.emptyReason
                                                                                        Definition

                                                                                        If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                        ShortWhy the section is empty
                                                                                        Comments

                                                                                        The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                        Control0..1
                                                                                        This element is affected by the following invariants: cmp-2
                                                                                        BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                        (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                                        If a section is empty, why it is empty.

                                                                                        TypeCodeableConcept
                                                                                        Is Modifierfalse
                                                                                        Summaryfalse
                                                                                        Requirements

                                                                                        Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        224. Composition.section:history_of_present_illness_section.section
                                                                                        Definition

                                                                                        A nested sub-section within this section.

                                                                                        ShortNested Section
                                                                                        Comments

                                                                                        Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                        Control0..*
                                                                                        This element is affected by the following invariants: cmp-1
                                                                                        TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                        Is Modifierfalse
                                                                                        Summaryfalse
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        226. Composition.section:problem_section
                                                                                        Slice Nameproblem_section
                                                                                        Definition

                                                                                        The root of the sections that make up the composition.

                                                                                        ShortProblem Section
                                                                                        Comments

                                                                                        Problem Section

                                                                                        Control1..1
                                                                                        TypeBackboneElement
                                                                                        Is Modifierfalse
                                                                                        Summaryfalse
                                                                                        LabelProblem Section
                                                                                        Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                        cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        228. Composition.section:problem_section.id
                                                                                        Definition

                                                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                        ShortUnique id for inter-element referencing
                                                                                        Control0..1
                                                                                        Typestring
                                                                                        Is Modifierfalse
                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                        Summaryfalse
                                                                                        230. Composition.section:problem_section.extension
                                                                                        Definition

                                                                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                        ShortAdditional content defined by implementations
                                                                                        Comments

                                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                        Control0..*
                                                                                        TypeExtension
                                                                                        Is Modifierfalse
                                                                                        Summaryfalse
                                                                                        Alternate Namesextensions, user content
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                        232. Composition.section:problem_section.modifierExtension
                                                                                        Definition

                                                                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                                                        Comments

                                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                        Control0..*
                                                                                        TypeExtension
                                                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                        Summarytrue
                                                                                        Requirements

                                                                                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                        Alternate Namesextensions, user content, modifiers
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                        234. Composition.section:problem_section.title
                                                                                        Definition

                                                                                        The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                        Shorttitle
                                                                                        Comments

                                                                                        The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                        Control1..1
                                                                                        Typestring
                                                                                        Is Modifierfalse
                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                        Must Supporttrue
                                                                                        Summaryfalse
                                                                                        Requirements

                                                                                        Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                        Alternate Namesheader, label, caption
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        236. Composition.section:problem_section.code
                                                                                        Definition

                                                                                        A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                        ShortProblem list
                                                                                        Comments

                                                                                        The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                        If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                        Control1..1
                                                                                        BindingFor example codes, see DocumentSectionCodes
                                                                                        (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                        Classification of a section of a composition/document.

                                                                                        TypeCodeableConcept
                                                                                        Is Modifierfalse
                                                                                        Must Supporttrue
                                                                                        Summaryfalse
                                                                                        Requirements

                                                                                        Provides computable standardized labels to topics within the document.

                                                                                        LabelProblem list
                                                                                        Pattern Value{
                                                                                          "coding" : [{
                                                                                            "system" : "http://loinc.org",
                                                                                            "code" : "11450-4"
                                                                                          }]
                                                                                        }
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        238. Composition.section:problem_section.author
                                                                                        Definition

                                                                                        Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                        ShortWho and/or what authored the section
                                                                                        Control0..*
                                                                                        TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                        Is Modifierfalse
                                                                                        Summaryfalse
                                                                                        Requirements

                                                                                        Identifies who is responsible for the content.

                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        240. Composition.section:problem_section.focus
                                                                                        Definition

                                                                                        The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                        ShortWho/what the section is about, when it is not about the subject of composition
                                                                                        Comments

                                                                                        Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                        Control0..1
                                                                                        TypeReference(Resource)
                                                                                        Is Modifierfalse
                                                                                        Summaryfalse
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        242. Composition.section:problem_section.text
                                                                                        Definition

                                                                                        A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                                        Shorttext
                                                                                        Comments

                                                                                        Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                        Control1..1
                                                                                        This element is affected by the following invariants: cmp-1
                                                                                        TypeNarrative
                                                                                        Is Modifierfalse
                                                                                        Summaryfalse
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        244. Composition.section:problem_section.mode
                                                                                        Definition

                                                                                        How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                        Shortworking | snapshot | changes
                                                                                        Comments

                                                                                        This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                        Control0..1
                                                                                        BindingThe codes SHALL be taken from ListMode
                                                                                        (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                        The processing mode that applies to this section.

                                                                                        Typecode
                                                                                        Is Modifierfalse
                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                        Summaryfalse
                                                                                        Requirements

                                                                                        Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        246. Composition.section:problem_section.orderedBy
                                                                                        Definition

                                                                                        Specifies the order applied to the items in the section entries.

                                                                                        ShortOrder of section entries
                                                                                        Comments

                                                                                        Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                        Control0..1
                                                                                        BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                        (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                        What order applies to the items in the entry.

                                                                                        TypeCodeableConcept
                                                                                        Is Modifierfalse
                                                                                        Summaryfalse
                                                                                        Requirements

                                                                                        Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        248. Composition.section:problem_section.entry
                                                                                        Definition

                                                                                        A reference to the actual resource from which the narrative in the section is derived.

                                                                                        Shortentry
                                                                                        Comments

                                                                                        If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                        Control0..*
                                                                                        This element is affected by the following invariants: cmp-2
                                                                                        TypeReference(Resource)
                                                                                        Is Modifierfalse
                                                                                        Summaryfalse
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                                        • profile @ resolve()
                                                                                        • 250. Composition.section:problem_section.entry:problem_section_entry
                                                                                          Slice Nameproblem_section_entry
                                                                                          Definition

                                                                                          A reference to the actual resource from which the narrative in the section is derived.

                                                                                          ShortA reference to data that supports this section
                                                                                          Comments

                                                                                          If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                          Control0..*
                                                                                          This element is affected by the following invariants: cmp-2
                                                                                          TypeReference(US Core Condition Profile)
                                                                                          Is Modifierfalse
                                                                                          Must Supporttrue
                                                                                          Summaryfalse
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          252. Composition.section:problem_section.emptyReason
                                                                                          Definition

                                                                                          If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                          ShortWhy the section is empty
                                                                                          Comments

                                                                                          The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                          Control0..1
                                                                                          This element is affected by the following invariants: cmp-2
                                                                                          BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                          (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                                          If a section is empty, why it is empty.

                                                                                          TypeCodeableConcept
                                                                                          Is Modifierfalse
                                                                                          Summaryfalse
                                                                                          Requirements

                                                                                          Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          254. Composition.section:problem_section.section
                                                                                          Definition

                                                                                          A nested sub-section within this section.

                                                                                          ShortNested Section
                                                                                          Comments

                                                                                          Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                          Control0..*
                                                                                          This element is affected by the following invariants: cmp-1
                                                                                          TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                          Is Modifierfalse
                                                                                          Summaryfalse
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          256. Composition.section:medications_section
                                                                                          Slice Namemedications_section
                                                                                          Definition

                                                                                          The root of the sections that make up the composition.

                                                                                          ShortMedications Section
                                                                                          Comments

                                                                                          Medications Section

                                                                                          Control0..1
                                                                                          TypeBackboneElement
                                                                                          Is Modifierfalse
                                                                                          Summaryfalse
                                                                                          LabelMedications Section
                                                                                          Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          258. Composition.section:medications_section.id
                                                                                          Definition

                                                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                          ShortUnique id for inter-element referencing
                                                                                          Control0..1
                                                                                          Typestring
                                                                                          Is Modifierfalse
                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                          Summaryfalse
                                                                                          260. Composition.section:medications_section.extension
                                                                                          Definition

                                                                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                          ShortAdditional content defined by implementations
                                                                                          Comments

                                                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                          Control0..*
                                                                                          TypeExtension
                                                                                          Is Modifierfalse
                                                                                          Summaryfalse
                                                                                          Alternate Namesextensions, user content
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                          262. Composition.section:medications_section.modifierExtension
                                                                                          Definition

                                                                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                                                          Comments

                                                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                          Control0..*
                                                                                          TypeExtension
                                                                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                          Summarytrue
                                                                                          Requirements

                                                                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                          Alternate Namesextensions, user content, modifiers
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                          264. Composition.section:medications_section.title
                                                                                          Definition

                                                                                          The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                          Shorttitle
                                                                                          Comments

                                                                                          The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                          Control1..1
                                                                                          Typestring
                                                                                          Is Modifierfalse
                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                          Summaryfalse
                                                                                          Requirements

                                                                                          Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                          Alternate Namesheader, label, caption
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          266. Composition.section:medications_section.code
                                                                                          Definition

                                                                                          A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                          ShortHistory of medication use
                                                                                          Comments

                                                                                          The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                          If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                          Control1..1
                                                                                          BindingFor example codes, see DocumentSectionCodes
                                                                                          (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                          Classification of a section of a composition/document.

                                                                                          TypeCodeableConcept
                                                                                          Is Modifierfalse
                                                                                          Summaryfalse
                                                                                          Requirements

                                                                                          Provides computable standardized labels to topics within the document.

                                                                                          LabelHistory of medication use
                                                                                          Pattern Value{
                                                                                            "coding" : [{
                                                                                              "system" : "http://loinc.org",
                                                                                              "code" : "10160-0"
                                                                                            }]
                                                                                          }
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          268. Composition.section:medications_section.author
                                                                                          Definition

                                                                                          Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                          ShortWho and/or what authored the section
                                                                                          Control0..*
                                                                                          TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                          Is Modifierfalse
                                                                                          Summaryfalse
                                                                                          Requirements

                                                                                          Identifies who is responsible for the content.

                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          270. Composition.section:medications_section.focus
                                                                                          Definition

                                                                                          The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                          ShortWho/what the section is about, when it is not about the subject of composition
                                                                                          Comments

                                                                                          Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                          Control0..1
                                                                                          TypeReference(Resource)
                                                                                          Is Modifierfalse
                                                                                          Summaryfalse
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          272. Composition.section:medications_section.text
                                                                                          Definition

                                                                                          A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                                          Shorttext
                                                                                          Comments

                                                                                          Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                          Control1..1
                                                                                          This element is affected by the following invariants: cmp-1
                                                                                          TypeNarrative
                                                                                          Is Modifierfalse
                                                                                          Summaryfalse
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          274. Composition.section:medications_section.mode
                                                                                          Definition

                                                                                          How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                          Shortworking | snapshot | changes
                                                                                          Comments

                                                                                          This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                          Control0..1
                                                                                          BindingThe codes SHALL be taken from ListMode
                                                                                          (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                          The processing mode that applies to this section.

                                                                                          Typecode
                                                                                          Is Modifierfalse
                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                          Summaryfalse
                                                                                          Requirements

                                                                                          Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          276. Composition.section:medications_section.orderedBy
                                                                                          Definition

                                                                                          Specifies the order applied to the items in the section entries.

                                                                                          ShortOrder of section entries
                                                                                          Comments

                                                                                          Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                          Control0..1
                                                                                          BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                          (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                          What order applies to the items in the entry.

                                                                                          TypeCodeableConcept
                                                                                          Is Modifierfalse
                                                                                          Summaryfalse
                                                                                          Requirements

                                                                                          Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          278. Composition.section:medications_section.entry
                                                                                          Definition

                                                                                          A reference to the actual resource from which the narrative in the section is derived.

                                                                                          Shortentry
                                                                                          Comments

                                                                                          If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                          Control0..*
                                                                                          This element is affected by the following invariants: cmp-2
                                                                                          TypeReference(Resource)
                                                                                          Is Modifierfalse
                                                                                          Summaryfalse
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                                          • profile @ resolve()
                                                                                          • 280. Composition.section:medications_section.entry:sliceEntry
                                                                                            Slice NamesliceEntry
                                                                                            Definition

                                                                                            A reference to the actual resource from which the narrative in the section is derived.

                                                                                            ShortA reference to data that supports this section
                                                                                            Comments

                                                                                            If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                            Control0..*
                                                                                            This element is affected by the following invariants: cmp-2
                                                                                            TypeReference(MedicationStatement, US Core Medication Profile, US Core MedicationRequest Profile)
                                                                                            Is Modifierfalse
                                                                                            Summaryfalse
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            282. Composition.section:medications_section.emptyReason
                                                                                            Definition

                                                                                            If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                            ShortWhy the section is empty
                                                                                            Comments

                                                                                            The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                            Control0..1
                                                                                            This element is affected by the following invariants: cmp-2
                                                                                            BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                            (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                                            If a section is empty, why it is empty.

                                                                                            TypeCodeableConcept
                                                                                            Is Modifierfalse
                                                                                            Summaryfalse
                                                                                            Requirements

                                                                                            Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            284. Composition.section:medications_section.section
                                                                                            Definition

                                                                                            A nested sub-section within this section.

                                                                                            ShortNested Section
                                                                                            Comments

                                                                                            Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                            Control0..*
                                                                                            This element is affected by the following invariants: cmp-1
                                                                                            TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                            Is Modifierfalse
                                                                                            Summaryfalse
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            286. Composition.section:physical_exam_section
                                                                                            Slice Namephysical_exam_section
                                                                                            Definition

                                                                                            The root of the sections that make up the composition.

                                                                                            ShortPhysical Exam Section
                                                                                            Comments

                                                                                            Physical Exam Section

                                                                                            Control0..1
                                                                                            TypeBackboneElement
                                                                                            Is Modifierfalse
                                                                                            Summaryfalse
                                                                                            LabelPhysical Exam Section
                                                                                            Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            288. Composition.section:physical_exam_section.id
                                                                                            Definition

                                                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                            ShortUnique id for inter-element referencing
                                                                                            Control0..1
                                                                                            Typestring
                                                                                            Is Modifierfalse
                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                            Summaryfalse
                                                                                            290. Composition.section:physical_exam_section.extension
                                                                                            Definition

                                                                                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                            ShortAdditional content defined by implementations
                                                                                            Comments

                                                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                            Control0..*
                                                                                            TypeExtension
                                                                                            Is Modifierfalse
                                                                                            Summaryfalse
                                                                                            Alternate Namesextensions, user content
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                            292. Composition.section:physical_exam_section.modifierExtension
                                                                                            Definition

                                                                                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                                                            Comments

                                                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                            Control0..*
                                                                                            TypeExtension
                                                                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                            Summarytrue
                                                                                            Requirements

                                                                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                            Alternate Namesextensions, user content, modifiers
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                            294. Composition.section:physical_exam_section.title
                                                                                            Definition

                                                                                            The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                            Shorttitle
                                                                                            Comments

                                                                                            The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                            Control1..1
                                                                                            Typestring
                                                                                            Is Modifierfalse
                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                            Summaryfalse
                                                                                            Requirements

                                                                                            Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                            Alternate Namesheader, label, caption
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            296. Composition.section:physical_exam_section.code
                                                                                            Definition

                                                                                            A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                            ShortPhysical findings
                                                                                            Comments

                                                                                            The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                            If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                            Control1..1
                                                                                            BindingFor example codes, see DocumentSectionCodes
                                                                                            (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                            Classification of a section of a composition/document.

                                                                                            TypeCodeableConcept
                                                                                            Is Modifierfalse
                                                                                            Summaryfalse
                                                                                            Requirements

                                                                                            Provides computable standardized labels to topics within the document.

                                                                                            LabelPhysical findings
                                                                                            Pattern Value{
                                                                                              "coding" : [{
                                                                                                "system" : "http://loinc.org",
                                                                                                "code" : "29545-1"
                                                                                              }]
                                                                                            }
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            298. Composition.section:physical_exam_section.author
                                                                                            Definition

                                                                                            Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                            ShortWho and/or what authored the section
                                                                                            Control0..*
                                                                                            TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                            Is Modifierfalse
                                                                                            Summaryfalse
                                                                                            Requirements

                                                                                            Identifies who is responsible for the content.

                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            300. Composition.section:physical_exam_section.focus
                                                                                            Definition

                                                                                            The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                            ShortWho/what the section is about, when it is not about the subject of composition
                                                                                            Comments

                                                                                            Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                            Control0..1
                                                                                            TypeReference(Resource)
                                                                                            Is Modifierfalse
                                                                                            Summaryfalse
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            302. Composition.section:physical_exam_section.text
                                                                                            Definition

                                                                                            A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                                            Shorttext
                                                                                            Comments

                                                                                            Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                            Control1..1
                                                                                            This element is affected by the following invariants: cmp-1
                                                                                            TypeNarrative
                                                                                            Is Modifierfalse
                                                                                            Summaryfalse
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            304. Composition.section:physical_exam_section.mode
                                                                                            Definition

                                                                                            How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                            Shortworking | snapshot | changes
                                                                                            Comments

                                                                                            This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                            Control0..1
                                                                                            BindingThe codes SHALL be taken from ListMode
                                                                                            (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                            The processing mode that applies to this section.

                                                                                            Typecode
                                                                                            Is Modifierfalse
                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                            Summaryfalse
                                                                                            Requirements

                                                                                            Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            306. Composition.section:physical_exam_section.orderedBy
                                                                                            Definition

                                                                                            Specifies the order applied to the items in the section entries.

                                                                                            ShortOrder of section entries
                                                                                            Comments

                                                                                            Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                            Control0..1
                                                                                            BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                            (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                            What order applies to the items in the entry.

                                                                                            TypeCodeableConcept
                                                                                            Is Modifierfalse
                                                                                            Summaryfalse
                                                                                            Requirements

                                                                                            Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            308. Composition.section:physical_exam_section.entry
                                                                                            Definition

                                                                                            A reference to the actual resource from which the narrative in the section is derived.

                                                                                            Shortentry
                                                                                            Comments

                                                                                            If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                            Control0..*
                                                                                            This element is affected by the following invariants: cmp-2
                                                                                            TypeReference(Resource)
                                                                                            Is Modifierfalse
                                                                                            Summaryfalse
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                                            • profile @ resolve()
                                                                                            • 310. Composition.section:physical_exam_section.entry:sliceEntry
                                                                                              Slice NamesliceEntry
                                                                                              Definition

                                                                                              A reference to the actual resource from which the narrative in the section is derived.

                                                                                              ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                                                                                              Comments

                                                                                              If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                              Control0..*
                                                                                              This element is affected by the following invariants: cmp-2
                                                                                              TypeReference(Observation)
                                                                                              Is Modifierfalse
                                                                                              Summaryfalse
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              312. Composition.section:physical_exam_section.emptyReason
                                                                                              Definition

                                                                                              If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                              ShortWhy the section is empty
                                                                                              Comments

                                                                                              The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                              Control0..1
                                                                                              This element is affected by the following invariants: cmp-2
                                                                                              BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                              (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                                              If a section is empty, why it is empty.

                                                                                              TypeCodeableConcept
                                                                                              Is Modifierfalse
                                                                                              Summaryfalse
                                                                                              Requirements

                                                                                              Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              314. Composition.section:physical_exam_section.section
                                                                                              Definition

                                                                                              A nested sub-section within this section.

                                                                                              ShortNested Section
                                                                                              Comments

                                                                                              Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                              Control0..*
                                                                                              This element is affected by the following invariants: cmp-1
                                                                                              TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                              Is Modifierfalse
                                                                                              Summaryfalse
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              316. Composition.section:results_section
                                                                                              Slice Nameresults_section
                                                                                              Definition

                                                                                              The root of the sections that make up the composition.

                                                                                              ShortResults Section
                                                                                              Comments

                                                                                              Results Section

                                                                                              Control0..1
                                                                                              TypeBackboneElement
                                                                                              Is Modifierfalse
                                                                                              Summaryfalse
                                                                                              LabelResults Section
                                                                                              Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              318. Composition.section:results_section.id
                                                                                              Definition

                                                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                              ShortUnique id for inter-element referencing
                                                                                              Control0..1
                                                                                              Typestring
                                                                                              Is Modifierfalse
                                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                                              Summaryfalse
                                                                                              320. Composition.section:results_section.extension
                                                                                              Definition

                                                                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                              ShortAdditional content defined by implementations
                                                                                              Comments

                                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                              Control0..*
                                                                                              TypeExtension
                                                                                              Is Modifierfalse
                                                                                              Summaryfalse
                                                                                              Alternate Namesextensions, user content
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                              322. Composition.section:results_section.modifierExtension
                                                                                              Definition

                                                                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                                                              Comments

                                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                              Control0..*
                                                                                              TypeExtension
                                                                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                              Summarytrue
                                                                                              Requirements

                                                                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                              Alternate Namesextensions, user content, modifiers
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                              324. Composition.section:results_section.title
                                                                                              Definition

                                                                                              The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                              Shorttitle
                                                                                              Comments

                                                                                              The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                              Control1..1
                                                                                              Typestring
                                                                                              Is Modifierfalse
                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                              Summaryfalse
                                                                                              Requirements

                                                                                              Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                              Alternate Namesheader, label, caption
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              326. Composition.section:results_section.code
                                                                                              Definition

                                                                                              A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                              ShortRelevant diagnostic tests/laboratory data
                                                                                              Comments

                                                                                              The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                              If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                              Control1..1
                                                                                              BindingFor example codes, see DocumentSectionCodes
                                                                                              (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                              Classification of a section of a composition/document.

                                                                                              TypeCodeableConcept
                                                                                              Is Modifierfalse
                                                                                              Summaryfalse
                                                                                              Requirements

                                                                                              Provides computable standardized labels to topics within the document.

                                                                                              LabelRelevant diagnostic tests/laboratory data
                                                                                              Pattern Value{
                                                                                                "coding" : [{
                                                                                                  "system" : "http://loinc.org",
                                                                                                  "code" : "30954-2"
                                                                                                }]
                                                                                              }
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              328. Composition.section:results_section.author
                                                                                              Definition

                                                                                              Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                              ShortWho and/or what authored the section
                                                                                              Control0..*
                                                                                              TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                              Is Modifierfalse
                                                                                              Summaryfalse
                                                                                              Requirements

                                                                                              Identifies who is responsible for the content.

                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              330. Composition.section:results_section.focus
                                                                                              Definition

                                                                                              The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                              ShortWho/what the section is about, when it is not about the subject of composition
                                                                                              Comments

                                                                                              Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                              Control0..1
                                                                                              TypeReference(Resource)
                                                                                              Is Modifierfalse
                                                                                              Summaryfalse
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              332. Composition.section:results_section.text
                                                                                              Definition

                                                                                              A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                                              Shorttext
                                                                                              Comments

                                                                                              Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                              Control1..1
                                                                                              This element is affected by the following invariants: cmp-1
                                                                                              TypeNarrative
                                                                                              Is Modifierfalse
                                                                                              Summaryfalse
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              334. Composition.section:results_section.mode
                                                                                              Definition

                                                                                              How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                              Shortworking | snapshot | changes
                                                                                              Comments

                                                                                              This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                              Control0..1
                                                                                              BindingThe codes SHALL be taken from ListMode
                                                                                              (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                              The processing mode that applies to this section.

                                                                                              Typecode
                                                                                              Is Modifierfalse
                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                              Summaryfalse
                                                                                              Requirements

                                                                                              Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              336. Composition.section:results_section.orderedBy
                                                                                              Definition

                                                                                              Specifies the order applied to the items in the section entries.

                                                                                              ShortOrder of section entries
                                                                                              Comments

                                                                                              Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                              Control0..1
                                                                                              BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                              (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                              What order applies to the items in the entry.

                                                                                              TypeCodeableConcept
                                                                                              Is Modifierfalse
                                                                                              Summaryfalse
                                                                                              Requirements

                                                                                              Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              338. Composition.section:results_section.entry
                                                                                              Definition

                                                                                              A reference to the actual resource from which the narrative in the section is derived.

                                                                                              Shortentry
                                                                                              Comments

                                                                                              If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                              Control0..*
                                                                                              This element is affected by the following invariants: cmp-2
                                                                                              TypeReference(Resource)
                                                                                              Is Modifierfalse
                                                                                              Summaryfalse
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                                              • profile @ resolve()
                                                                                              • 340. Composition.section:results_section.entry:sliceEntry
                                                                                                Slice NamesliceEntry
                                                                                                Definition

                                                                                                A reference to the actual resource from which the narrative in the section is derived.

                                                                                                ShortA reference to data that supports this section
                                                                                                Comments

                                                                                                If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                Control0..*
                                                                                                This element is affected by the following invariants: cmp-2
                                                                                                TypeReference(US Core Laboratory Result Observation Profile)
                                                                                                Is Modifierfalse
                                                                                                Summaryfalse
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                342. Composition.section:results_section.emptyReason
                                                                                                Definition

                                                                                                If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                ShortWhy the section is empty
                                                                                                Comments

                                                                                                The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                Control0..1
                                                                                                This element is affected by the following invariants: cmp-2
                                                                                                BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                                (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                                                If a section is empty, why it is empty.

                                                                                                TypeCodeableConcept
                                                                                                Is Modifierfalse
                                                                                                Summaryfalse
                                                                                                Requirements

                                                                                                Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                344. Composition.section:results_section.section
                                                                                                Definition

                                                                                                A nested sub-section within this section.

                                                                                                ShortNested Section
                                                                                                Comments

                                                                                                Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                Control0..*
                                                                                                This element is affected by the following invariants: cmp-1
                                                                                                TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                Is Modifierfalse
                                                                                                Summaryfalse
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                346. Composition.section:advance_directives_section
                                                                                                Slice Nameadvance_directives_section
                                                                                                Definition

                                                                                                The root of the sections that make up the composition.

                                                                                                ShortAdvance Directives Section
                                                                                                Comments

                                                                                                Advance Directives Section

                                                                                                Control0..1
                                                                                                TypeBackboneElement
                                                                                                Is Modifierfalse
                                                                                                Must Supporttrue
                                                                                                Summaryfalse
                                                                                                LabelAdvance Directives Section
                                                                                                Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                348. Composition.section:advance_directives_section.id
                                                                                                Definition

                                                                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                ShortUnique id for inter-element referencing
                                                                                                Control0..1
                                                                                                Typestring
                                                                                                Is Modifierfalse
                                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                Summaryfalse
                                                                                                350. Composition.section:advance_directives_section.extension
                                                                                                Definition

                                                                                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                ShortAdditional content defined by implementations
                                                                                                Comments

                                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                Control0..*
                                                                                                TypeExtension
                                                                                                Is Modifierfalse
                                                                                                Summaryfalse
                                                                                                Alternate Namesextensions, user content
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                352. Composition.section:advance_directives_section.modifierExtension
                                                                                                Definition

                                                                                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                                                Comments

                                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                Control0..*
                                                                                                TypeExtension
                                                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                Summarytrue
                                                                                                Requirements

                                                                                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                Alternate Namesextensions, user content, modifiers
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                354. Composition.section:advance_directives_section.title
                                                                                                Definition

                                                                                                The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                Shorttitle
                                                                                                Comments

                                                                                                The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                Control1..1
                                                                                                Typestring
                                                                                                Is Modifierfalse
                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                Must Supporttrue
                                                                                                Summaryfalse
                                                                                                Requirements

                                                                                                Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                Alternate Namesheader, label, caption
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                356. Composition.section:advance_directives_section.code
                                                                                                Definition

                                                                                                A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                ShortAdvance directives
                                                                                                Comments

                                                                                                The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                Control1..1
                                                                                                BindingFor example codes, see DocumentSectionCodes
                                                                                                (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                                Classification of a section of a composition/document.

                                                                                                TypeCodeableConcept
                                                                                                Is Modifierfalse
                                                                                                Must Supporttrue
                                                                                                Summaryfalse
                                                                                                Requirements

                                                                                                Provides computable standardized labels to topics within the document.

                                                                                                LabelAdvance directives
                                                                                                Pattern Value{
                                                                                                  "coding" : [{
                                                                                                    "system" : "http://loinc.org",
                                                                                                    "code" : "42348-3"
                                                                                                  }]
                                                                                                }
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                358. Composition.section:advance_directives_section.author
                                                                                                Definition

                                                                                                Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                                ShortWho and/or what authored the section
                                                                                                Control0..*
                                                                                                TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                Is Modifierfalse
                                                                                                Summaryfalse
                                                                                                Requirements

                                                                                                Identifies who is responsible for the content.

                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                360. Composition.section:advance_directives_section.focus
                                                                                                Definition

                                                                                                The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                Comments

                                                                                                Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                                Control0..1
                                                                                                TypeReference(Resource)
                                                                                                Is Modifierfalse
                                                                                                Summaryfalse
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                362. Composition.section:advance_directives_section.text
                                                                                                Definition

                                                                                                A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                                                Shorttext
                                                                                                Comments

                                                                                                Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                Control1..1
                                                                                                This element is affected by the following invariants: cmp-1
                                                                                                TypeNarrative
                                                                                                Is Modifierfalse
                                                                                                Must Supporttrue
                                                                                                Summaryfalse
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                364. Composition.section:advance_directives_section.mode
                                                                                                Definition

                                                                                                How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                Shortworking | snapshot | changes
                                                                                                Comments

                                                                                                This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                Control0..1
                                                                                                BindingThe codes SHALL be taken from ListMode
                                                                                                (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                The processing mode that applies to this section.

                                                                                                Typecode
                                                                                                Is Modifierfalse
                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                Summaryfalse
                                                                                                Requirements

                                                                                                Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                366. Composition.section:advance_directives_section.orderedBy
                                                                                                Definition

                                                                                                Specifies the order applied to the items in the section entries.

                                                                                                ShortOrder of section entries
                                                                                                Comments

                                                                                                Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                Control0..1
                                                                                                BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                                What order applies to the items in the entry.

                                                                                                TypeCodeableConcept
                                                                                                Is Modifierfalse
                                                                                                Summaryfalse
                                                                                                Requirements

                                                                                                Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                368. Composition.section:advance_directives_section.entry
                                                                                                Definition

                                                                                                A reference to the actual resource from which the narrative in the section is derived.

                                                                                                ShortA reference to data that supports this section
                                                                                                Comments

                                                                                                If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                Control0..*
                                                                                                This element is affected by the following invariants: cmp-2
                                                                                                TypeReference(Resource)
                                                                                                Is Modifierfalse
                                                                                                Summaryfalse
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                                                • profile @ resolve()
                                                                                                • 370. Composition.section:advance_directives_section.entry:advance_directive_entry
                                                                                                  Slice Nameadvance_directive_entry
                                                                                                  Definition

                                                                                                  A reference to the actual resource from which the narrative in the section is derived.

                                                                                                  ShortA reference to data that supports this section
                                                                                                  Comments

                                                                                                  If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                  Control0..*
                                                                                                  This element is affected by the following invariants: cmp-2
                                                                                                  TypeReference(Consent)
                                                                                                  Is Modifierfalse
                                                                                                  Must Supporttrue
                                                                                                  Summaryfalse
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  372. Composition.section:advance_directives_section.emptyReason
                                                                                                  Definition

                                                                                                  If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                  ShortWhy the section is empty
                                                                                                  Comments

                                                                                                  The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                  Control0..1
                                                                                                  This element is affected by the following invariants: cmp-2
                                                                                                  BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                                  (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                                                  If a section is empty, why it is empty.

                                                                                                  TypeCodeableConcept
                                                                                                  Is Modifierfalse
                                                                                                  Summaryfalse
                                                                                                  Requirements

                                                                                                  Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  374. Composition.section:advance_directives_section.section
                                                                                                  Definition

                                                                                                  A nested sub-section within this section.

                                                                                                  ShortNested Section
                                                                                                  Comments

                                                                                                  Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                  Control0..*
                                                                                                  This element is affected by the following invariants: cmp-1
                                                                                                  TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                  Is Modifierfalse
                                                                                                  Summaryfalse
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  376. Composition.section:assessment_and_plan_section
                                                                                                  Slice Nameassessment_and_plan_section
                                                                                                  Definition

                                                                                                  The root of the sections that make up the composition.

                                                                                                  ShortAssessment and Plan Section. This section represents the clinician’s conclusions and working assumptions that will guide treatment of the patient. The Assessment and Plan Section may be combined or separated to meet local policy requirements.
                                                                                                  Comments

                                                                                                  Assessment and Plan Section

                                                                                                  Control0..1
                                                                                                  TypeBackboneElement
                                                                                                  Is Modifierfalse
                                                                                                  Summaryfalse
                                                                                                  LabelAssessment and Plan Section
                                                                                                  Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                  cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                  ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  378. Composition.section:assessment_and_plan_section.id
                                                                                                  Definition

                                                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                  ShortUnique id for inter-element referencing
                                                                                                  Control0..1
                                                                                                  Typestring
                                                                                                  Is Modifierfalse
                                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                  Summaryfalse
                                                                                                  380. Composition.section:assessment_and_plan_section.extension
                                                                                                  Definition

                                                                                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                  ShortAdditional content defined by implementations
                                                                                                  Comments

                                                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                  Control0..*
                                                                                                  TypeExtension
                                                                                                  Is Modifierfalse
                                                                                                  Summaryfalse
                                                                                                  Alternate Namesextensions, user content
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                  382. Composition.section:assessment_and_plan_section.modifierExtension
                                                                                                  Definition

                                                                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                                                                  Comments

                                                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                  Control0..*
                                                                                                  TypeExtension
                                                                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                  Summarytrue
                                                                                                  Requirements

                                                                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                  Alternate Namesextensions, user content, modifiers
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                  384. Composition.section:assessment_and_plan_section.title
                                                                                                  Definition

                                                                                                  The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                  Shorttitle
                                                                                                  Comments

                                                                                                  The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                  Control1..1
                                                                                                  Typestring
                                                                                                  Is Modifierfalse
                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                  Summaryfalse
                                                                                                  Requirements

                                                                                                  Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                  Alternate Namesheader, label, caption
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  386. Composition.section:assessment_and_plan_section.code
                                                                                                  Definition

                                                                                                  A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                  ShortAssessment (evaluation) and plan
                                                                                                  Comments

                                                                                                  The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                  If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                  Control1..1
                                                                                                  BindingFor example codes, see DocumentSectionCodes
                                                                                                  (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                                  Classification of a section of a composition/document.

                                                                                                  TypeCodeableConcept
                                                                                                  Is Modifierfalse
                                                                                                  Summaryfalse
                                                                                                  Requirements

                                                                                                  Provides computable standardized labels to topics within the document.

                                                                                                  LabelAssessment (evaluation) and plan
                                                                                                  Pattern Value{
                                                                                                    "coding" : [{
                                                                                                      "system" : "http://loinc.org",
                                                                                                      "code" : "51847-2"
                                                                                                    }]
                                                                                                  }
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  388. Composition.section:assessment_and_plan_section.author
                                                                                                  Definition

                                                                                                  Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                                  ShortWho and/or what authored the section
                                                                                                  Control0..*
                                                                                                  TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                  Is Modifierfalse
                                                                                                  Summaryfalse
                                                                                                  Requirements

                                                                                                  Identifies who is responsible for the content.

                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  390. Composition.section:assessment_and_plan_section.focus
                                                                                                  Definition

                                                                                                  The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                  ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                  Comments

                                                                                                  Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                                  Control0..1
                                                                                                  TypeReference(Resource)
                                                                                                  Is Modifierfalse
                                                                                                  Summaryfalse
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  392. Composition.section:assessment_and_plan_section.text
                                                                                                  Definition

                                                                                                  A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                                                  Shorttext
                                                                                                  Comments

                                                                                                  Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                  Control1..1
                                                                                                  This element is affected by the following invariants: cmp-1
                                                                                                  TypeNarrative
                                                                                                  Is Modifierfalse
                                                                                                  Summaryfalse
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  394. Composition.section:assessment_and_plan_section.mode
                                                                                                  Definition

                                                                                                  How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                  Shortworking | snapshot | changes
                                                                                                  Comments

                                                                                                  This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                  Control0..1
                                                                                                  BindingThe codes SHALL be taken from ListMode
                                                                                                  (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                  The processing mode that applies to this section.

                                                                                                  Typecode
                                                                                                  Is Modifierfalse
                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                  Summaryfalse
                                                                                                  Requirements

                                                                                                  Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  396. Composition.section:assessment_and_plan_section.orderedBy
                                                                                                  Definition

                                                                                                  Specifies the order applied to the items in the section entries.

                                                                                                  ShortOrder of section entries
                                                                                                  Comments

                                                                                                  Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                  Control0..1
                                                                                                  BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                  (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                                  What order applies to the items in the entry.

                                                                                                  TypeCodeableConcept
                                                                                                  Is Modifierfalse
                                                                                                  Summaryfalse
                                                                                                  Requirements

                                                                                                  Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  398. Composition.section:assessment_and_plan_section.entry
                                                                                                  Definition

                                                                                                  A reference to the actual resource from which the narrative in the section is derived.

                                                                                                  ShortA reference to data that supports this section
                                                                                                  Comments

                                                                                                  If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                  Control0..*
                                                                                                  This element is affected by the following invariants: cmp-2
                                                                                                  TypeReference(Resource)
                                                                                                  Is Modifierfalse
                                                                                                  Summaryfalse
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                                                  • profile @ resolve()
                                                                                                  • 400. Composition.section:assessment_and_plan_section.entry:sliceEntry
                                                                                                    Slice NamesliceEntry
                                                                                                    Definition

                                                                                                    A reference to the actual resource from which the narrative in the section is derived.

                                                                                                    ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                                                                                                    Comments

                                                                                                    If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                    Control0..*
                                                                                                    This element is affected by the following invariants: cmp-2
                                                                                                    TypeReference(US Core Condition Profile, Observation, Communication)
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    402. Composition.section:assessment_and_plan_section.emptyReason
                                                                                                    Definition

                                                                                                    If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                    ShortWhy the section is empty
                                                                                                    Comments

                                                                                                    The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                    Control0..1
                                                                                                    This element is affected by the following invariants: cmp-2
                                                                                                    BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                                    (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                                                    If a section is empty, why it is empty.

                                                                                                    TypeCodeableConcept
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Requirements

                                                                                                    Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    404. Composition.section:assessment_and_plan_section.section
                                                                                                    Definition

                                                                                                    A nested sub-section within this section.

                                                                                                    ShortNested Section
                                                                                                    Comments

                                                                                                    Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                    Control0..*
                                                                                                    This element is affected by the following invariants: cmp-1
                                                                                                    TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    406. Composition.section:assessment_section
                                                                                                    Slice Nameassessment_section
                                                                                                    Definition

                                                                                                    The root of the sections that make up the composition.

                                                                                                    ShortAssessment Section
                                                                                                    Comments

                                                                                                    Assessment Section

                                                                                                    Control0..1
                                                                                                    TypeBackboneElement
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    LabelAssessment Section
                                                                                                    Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    408. Composition.section:assessment_section.id
                                                                                                    Definition

                                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                    ShortUnique id for inter-element referencing
                                                                                                    Control0..1
                                                                                                    Typestring
                                                                                                    Is Modifierfalse
                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                    Summaryfalse
                                                                                                    410. Composition.section:assessment_section.extension
                                                                                                    Definition

                                                                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                    ShortAdditional content defined by implementations
                                                                                                    Comments

                                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                    Control0..*
                                                                                                    TypeExtension
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Alternate Namesextensions, user content
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                    412. Composition.section:assessment_section.modifierExtension
                                                                                                    Definition

                                                                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                                                    Comments

                                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                    Control0..*
                                                                                                    TypeExtension
                                                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                    Summarytrue
                                                                                                    Requirements

                                                                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                    Alternate Namesextensions, user content, modifiers
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                    414. Composition.section:assessment_section.title
                                                                                                    Definition

                                                                                                    The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                    Shorttitle
                                                                                                    Comments

                                                                                                    The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                    Control1..1
                                                                                                    Typestring
                                                                                                    Is Modifierfalse
                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                    Summaryfalse
                                                                                                    Requirements

                                                                                                    Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                    Alternate Namesheader, label, caption
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    416. Composition.section:assessment_section.code
                                                                                                    Definition

                                                                                                    A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                    ShortAssessments (evaluation)
                                                                                                    Comments

                                                                                                    The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                    If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                    Control1..1
                                                                                                    BindingFor example codes, see DocumentSectionCodes
                                                                                                    (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                                    Classification of a section of a composition/document.

                                                                                                    TypeCodeableConcept
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Requirements

                                                                                                    Provides computable standardized labels to topics within the document.

                                                                                                    LabelAssessments (evaluation)
                                                                                                    Pattern Value{
                                                                                                      "coding" : [{
                                                                                                        "system" : "http://loinc.org",
                                                                                                        "code" : "51848-0"
                                                                                                      }]
                                                                                                    }
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    418. Composition.section:assessment_section.author
                                                                                                    Definition

                                                                                                    Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                                    ShortWho and/or what authored the section
                                                                                                    Control0..*
                                                                                                    TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Requirements

                                                                                                    Identifies who is responsible for the content.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    420. Composition.section:assessment_section.focus
                                                                                                    Definition

                                                                                                    The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                    ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                    Comments

                                                                                                    Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                                    Control0..1
                                                                                                    TypeReference(Resource)
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    422. Composition.section:assessment_section.text
                                                                                                    Definition

                                                                                                    A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                                                    ShortThis section contains only human readable content
                                                                                                    Comments

                                                                                                    Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                    Control1..1
                                                                                                    This element is affected by the following invariants: cmp-1
                                                                                                    TypeNarrative
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    424. Composition.section:assessment_section.mode
                                                                                                    Definition

                                                                                                    How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                    Shortworking | snapshot | changes
                                                                                                    Comments

                                                                                                    This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                    Control0..1
                                                                                                    BindingThe codes SHALL be taken from ListMode
                                                                                                    (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                    The processing mode that applies to this section.

                                                                                                    Typecode
                                                                                                    Is Modifierfalse
                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                    Summaryfalse
                                                                                                    Requirements

                                                                                                    Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    426. Composition.section:assessment_section.orderedBy
                                                                                                    Definition

                                                                                                    Specifies the order applied to the items in the section entries.

                                                                                                    ShortOrder of section entries
                                                                                                    Comments

                                                                                                    Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                    Control0..1
                                                                                                    BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                    (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                                    What order applies to the items in the entry.

                                                                                                    TypeCodeableConcept
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Requirements

                                                                                                    Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    428. Composition.section:assessment_section.entry
                                                                                                    Definition

                                                                                                    A reference to the actual resource from which the narrative in the section is derived.

                                                                                                    ShortA reference to data that supports this section
                                                                                                    Comments

                                                                                                    If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                    Control0..*
                                                                                                    This element is affected by the following invariants: cmp-2
                                                                                                    TypeReference(Resource)
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    430. Composition.section:assessment_section.emptyReason
                                                                                                    Definition

                                                                                                    If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                    ShortWhy the section is empty
                                                                                                    Comments

                                                                                                    The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                    Control0..1
                                                                                                    This element is affected by the following invariants: cmp-2
                                                                                                    BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                                    (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                                                    If a section is empty, why it is empty.

                                                                                                    TypeCodeableConcept
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Requirements

                                                                                                    Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    432. Composition.section:assessment_section.section
                                                                                                    Definition

                                                                                                    A nested sub-section within this section.

                                                                                                    ShortNested Section
                                                                                                    Comments

                                                                                                    Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                    Control0..*
                                                                                                    This element is affected by the following invariants: cmp-1
                                                                                                    TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    434. Composition.section:chief_complaint_and_reason_for_visit_section
                                                                                                    Slice Namechief_complaint_and_reason_for_visit_section
                                                                                                    Definition

                                                                                                    The root of the sections that make up the composition.

                                                                                                    ShortChief Complaint and Reason for Visit Section. This section records the patient's chief complaint (the patient’s own description) and/or the reason for the patient's visit (the provider’s description of the reason for visit). Local policy determines whether the information is divided into two sections or recorded in one section serving both purposes.
                                                                                                    Comments

                                                                                                    Chief Complaint and Reason for Visit Section

                                                                                                    Control0..1
                                                                                                    TypeBackboneElement
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    LabelChief Complaint and Reason for Visit Section
                                                                                                    Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    436. Composition.section:chief_complaint_and_reason_for_visit_section.id
                                                                                                    Definition

                                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                    ShortUnique id for inter-element referencing
                                                                                                    Control0..1
                                                                                                    Typestring
                                                                                                    Is Modifierfalse
                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                    Summaryfalse
                                                                                                    438. Composition.section:chief_complaint_and_reason_for_visit_section.extension
                                                                                                    Definition

                                                                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                    ShortAdditional content defined by implementations
                                                                                                    Comments

                                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                    Control0..*
                                                                                                    TypeExtension
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Alternate Namesextensions, user content
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                    440. Composition.section:chief_complaint_and_reason_for_visit_section.modifierExtension
                                                                                                    Definition

                                                                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                                                    Comments

                                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                    Control0..*
                                                                                                    TypeExtension
                                                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                    Summarytrue
                                                                                                    Requirements

                                                                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                    Alternate Namesextensions, user content, modifiers
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                    442. Composition.section:chief_complaint_and_reason_for_visit_section.title
                                                                                                    Definition

                                                                                                    The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                    Shorttitle
                                                                                                    Comments

                                                                                                    The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                    Control1..1
                                                                                                    Typestring
                                                                                                    Is Modifierfalse
                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                    Summaryfalse
                                                                                                    Requirements

                                                                                                    Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                    Alternate Namesheader, label, caption
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    444. Composition.section:chief_complaint_and_reason_for_visit_section.code
                                                                                                    Definition

                                                                                                    A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                    ShortChief complaint and reason for visit
                                                                                                    Comments

                                                                                                    The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                    If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                    Control1..1
                                                                                                    BindingFor example codes, see DocumentSectionCodes
                                                                                                    (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                                    Classification of a section of a composition/document.

                                                                                                    TypeCodeableConcept
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Requirements

                                                                                                    Provides computable standardized labels to topics within the document.

                                                                                                    LabelChief complaint and reason for visit
                                                                                                    Pattern Value{
                                                                                                      "coding" : [{
                                                                                                        "system" : "http://loinc.org",
                                                                                                        "code" : "46239-0"
                                                                                                      }]
                                                                                                    }
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    446. Composition.section:chief_complaint_and_reason_for_visit_section.author
                                                                                                    Definition

                                                                                                    Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                                    ShortWho and/or what authored the section
                                                                                                    Control0..*
                                                                                                    TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Requirements

                                                                                                    Identifies who is responsible for the content.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    448. Composition.section:chief_complaint_and_reason_for_visit_section.focus
                                                                                                    Definition

                                                                                                    The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                    ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                    Comments

                                                                                                    Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                                    Control0..1
                                                                                                    TypeReference(Resource)
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    450. Composition.section:chief_complaint_and_reason_for_visit_section.text
                                                                                                    Definition

                                                                                                    A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                                                    ShortThis section contains only human readable content
                                                                                                    Comments

                                                                                                    Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                    Control1..1
                                                                                                    This element is affected by the following invariants: cmp-1
                                                                                                    TypeNarrative
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    452. Composition.section:chief_complaint_and_reason_for_visit_section.mode
                                                                                                    Definition

                                                                                                    How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                    Shortworking | snapshot | changes
                                                                                                    Comments

                                                                                                    This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                    Control0..1
                                                                                                    BindingThe codes SHALL be taken from ListMode
                                                                                                    (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                    The processing mode that applies to this section.

                                                                                                    Typecode
                                                                                                    Is Modifierfalse
                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                    Summaryfalse
                                                                                                    Requirements

                                                                                                    Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    454. Composition.section:chief_complaint_and_reason_for_visit_section.orderedBy
                                                                                                    Definition

                                                                                                    Specifies the order applied to the items in the section entries.

                                                                                                    ShortOrder of section entries
                                                                                                    Comments

                                                                                                    Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                    Control0..1
                                                                                                    BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                    (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                                    What order applies to the items in the entry.

                                                                                                    TypeCodeableConcept
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Requirements

                                                                                                    Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    456. Composition.section:chief_complaint_and_reason_for_visit_section.entry
                                                                                                    Definition

                                                                                                    A reference to the actual resource from which the narrative in the section is derived.

                                                                                                    ShortA reference to data that supports this section
                                                                                                    Comments

                                                                                                    If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                    Control0..*
                                                                                                    This element is affected by the following invariants: cmp-2
                                                                                                    TypeReference(Resource)
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    458. Composition.section:chief_complaint_and_reason_for_visit_section.emptyReason
                                                                                                    Definition

                                                                                                    If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                    ShortWhy the section is empty
                                                                                                    Comments

                                                                                                    The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                    Control0..1
                                                                                                    This element is affected by the following invariants: cmp-2
                                                                                                    BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                                    (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                                                    If a section is empty, why it is empty.

                                                                                                    TypeCodeableConcept
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Requirements

                                                                                                    Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    460. Composition.section:chief_complaint_and_reason_for_visit_section.section
                                                                                                    Definition

                                                                                                    A nested sub-section within this section.

                                                                                                    ShortNested Section
                                                                                                    Comments

                                                                                                    Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                    Control0..*
                                                                                                    This element is affected by the following invariants: cmp-1
                                                                                                    TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    462. Composition.section:chief_complaint_section
                                                                                                    Slice Namechief_complaint_section
                                                                                                    Definition

                                                                                                    The root of the sections that make up the composition.

                                                                                                    ShortChief Complaint Section
                                                                                                    Comments

                                                                                                    Chief Complaint Section

                                                                                                    Control0..1
                                                                                                    TypeBackboneElement
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    LabelChief Complaint Section
                                                                                                    Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    464. Composition.section:chief_complaint_section.id
                                                                                                    Definition

                                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                    ShortUnique id for inter-element referencing
                                                                                                    Control0..1
                                                                                                    Typestring
                                                                                                    Is Modifierfalse
                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                    Summaryfalse
                                                                                                    466. Composition.section:chief_complaint_section.extension
                                                                                                    Definition

                                                                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                    ShortAdditional content defined by implementations
                                                                                                    Comments

                                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                    Control0..*
                                                                                                    TypeExtension
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Alternate Namesextensions, user content
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                    468. Composition.section:chief_complaint_section.modifierExtension
                                                                                                    Definition

                                                                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                                                    Comments

                                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                    Control0..*
                                                                                                    TypeExtension
                                                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                    Summarytrue
                                                                                                    Requirements

                                                                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                    Alternate Namesextensions, user content, modifiers
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                    470. Composition.section:chief_complaint_section.title
                                                                                                    Definition

                                                                                                    The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                    Shorttitle
                                                                                                    Comments

                                                                                                    The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                    Control1..1
                                                                                                    Typestring
                                                                                                    Is Modifierfalse
                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                    Summaryfalse
                                                                                                    Requirements

                                                                                                    Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                    Alternate Namesheader, label, caption
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    472. Composition.section:chief_complaint_section.code
                                                                                                    Definition

                                                                                                    A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                    ShortChief complaint
                                                                                                    Comments

                                                                                                    The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                    If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                    Control1..1
                                                                                                    BindingFor example codes, see DocumentSectionCodes
                                                                                                    (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                                    Classification of a section of a composition/document.

                                                                                                    TypeCodeableConcept
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Requirements

                                                                                                    Provides computable standardized labels to topics within the document.

                                                                                                    LabelChief complaint
                                                                                                    Pattern Value{
                                                                                                      "coding" : [{
                                                                                                        "system" : "http://loinc.org",
                                                                                                        "code" : "10154-3"
                                                                                                      }]
                                                                                                    }
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    474. Composition.section:chief_complaint_section.author
                                                                                                    Definition

                                                                                                    Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                                    ShortWho and/or what authored the section
                                                                                                    Control0..*
                                                                                                    TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Requirements

                                                                                                    Identifies who is responsible for the content.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    476. Composition.section:chief_complaint_section.focus
                                                                                                    Definition

                                                                                                    The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                    ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                    Comments

                                                                                                    Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                                    Control0..1
                                                                                                    TypeReference(Resource)
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    478. Composition.section:chief_complaint_section.text
                                                                                                    Definition

                                                                                                    A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                                                    ShortThis section contains only human readable content
                                                                                                    Comments

                                                                                                    Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                    Control1..1
                                                                                                    This element is affected by the following invariants: cmp-1
                                                                                                    TypeNarrative
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    480. Composition.section:chief_complaint_section.mode
                                                                                                    Definition

                                                                                                    How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                    Shortworking | snapshot | changes
                                                                                                    Comments

                                                                                                    This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                    Control0..1
                                                                                                    BindingThe codes SHALL be taken from ListMode
                                                                                                    (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                    The processing mode that applies to this section.

                                                                                                    Typecode
                                                                                                    Is Modifierfalse
                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                    Summaryfalse
                                                                                                    Requirements

                                                                                                    Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    482. Composition.section:chief_complaint_section.orderedBy
                                                                                                    Definition

                                                                                                    Specifies the order applied to the items in the section entries.

                                                                                                    ShortOrder of section entries
                                                                                                    Comments

                                                                                                    Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                    Control0..1
                                                                                                    BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                    (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                                    What order applies to the items in the entry.

                                                                                                    TypeCodeableConcept
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Requirements

                                                                                                    Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    484. Composition.section:chief_complaint_section.entry
                                                                                                    Definition

                                                                                                    A reference to the actual resource from which the narrative in the section is derived.

                                                                                                    ShortA reference to data that supports this section
                                                                                                    Comments

                                                                                                    If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                    Control0..*
                                                                                                    This element is affected by the following invariants: cmp-2
                                                                                                    TypeReference(Resource)
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    486. Composition.section:chief_complaint_section.emptyReason
                                                                                                    Definition

                                                                                                    If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                    ShortWhy the section is empty
                                                                                                    Comments

                                                                                                    The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                    Control0..1
                                                                                                    This element is affected by the following invariants: cmp-2
                                                                                                    BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                                    (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                                                    If a section is empty, why it is empty.

                                                                                                    TypeCodeableConcept
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Requirements

                                                                                                    Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    488. Composition.section:chief_complaint_section.section
                                                                                                    Definition

                                                                                                    A nested sub-section within this section.

                                                                                                    ShortNested Section
                                                                                                    Comments

                                                                                                    Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                    Control0..*
                                                                                                    This element is affected by the following invariants: cmp-1
                                                                                                    TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    490. Composition.section:family_history_section
                                                                                                    Slice Namefamily_history_section
                                                                                                    Definition

                                                                                                    The root of the sections that make up the composition.

                                                                                                    ShortFamily History Section
                                                                                                    Comments

                                                                                                    Family History Section

                                                                                                    Control0..1
                                                                                                    TypeBackboneElement
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    LabelFamily History Section
                                                                                                    Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    492. Composition.section:family_history_section.id
                                                                                                    Definition

                                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                    ShortUnique id for inter-element referencing
                                                                                                    Control0..1
                                                                                                    Typestring
                                                                                                    Is Modifierfalse
                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                    Summaryfalse
                                                                                                    494. Composition.section:family_history_section.extension
                                                                                                    Definition

                                                                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                    ShortAdditional content defined by implementations
                                                                                                    Comments

                                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                    Control0..*
                                                                                                    TypeExtension
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Alternate Namesextensions, user content
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                    496. Composition.section:family_history_section.modifierExtension
                                                                                                    Definition

                                                                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                                                    Comments

                                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                    Control0..*
                                                                                                    TypeExtension
                                                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                    Summarytrue
                                                                                                    Requirements

                                                                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                    Alternate Namesextensions, user content, modifiers
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                    498. Composition.section:family_history_section.title
                                                                                                    Definition

                                                                                                    The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                    Shorttitle
                                                                                                    Comments

                                                                                                    The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                    Control1..1
                                                                                                    Typestring
                                                                                                    Is Modifierfalse
                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                    Summaryfalse
                                                                                                    Requirements

                                                                                                    Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                    Alternate Namesheader, label, caption
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    500. Composition.section:family_history_section.code
                                                                                                    Definition

                                                                                                    A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                    ShortFamily history
                                                                                                    Comments

                                                                                                    The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                    If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                    Control1..1
                                                                                                    BindingFor example codes, see DocumentSectionCodes
                                                                                                    (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                                    Classification of a section of a composition/document.

                                                                                                    TypeCodeableConcept
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Requirements

                                                                                                    Provides computable standardized labels to topics within the document.

                                                                                                    LabelFamily history
                                                                                                    Pattern Value{
                                                                                                      "coding" : [{
                                                                                                        "system" : "http://loinc.org",
                                                                                                        "code" : "10157-6"
                                                                                                      }]
                                                                                                    }
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    502. Composition.section:family_history_section.author
                                                                                                    Definition

                                                                                                    Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                                    ShortWho and/or what authored the section
                                                                                                    Control0..*
                                                                                                    TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Requirements

                                                                                                    Identifies who is responsible for the content.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    504. Composition.section:family_history_section.focus
                                                                                                    Definition

                                                                                                    The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                    ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                    Comments

                                                                                                    Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                                    Control0..1
                                                                                                    TypeReference(Resource)
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    506. Composition.section:family_history_section.text
                                                                                                    Definition

                                                                                                    A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                                                    Shorttext
                                                                                                    Comments

                                                                                                    Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                    Control1..1
                                                                                                    This element is affected by the following invariants: cmp-1
                                                                                                    TypeNarrative
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    508. Composition.section:family_history_section.mode
                                                                                                    Definition

                                                                                                    How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                    Shortworking | snapshot | changes
                                                                                                    Comments

                                                                                                    This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                    Control0..1
                                                                                                    BindingThe codes SHALL be taken from ListMode
                                                                                                    (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                    The processing mode that applies to this section.

                                                                                                    Typecode
                                                                                                    Is Modifierfalse
                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                    Summaryfalse
                                                                                                    Requirements

                                                                                                    Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    510. Composition.section:family_history_section.orderedBy
                                                                                                    Definition

                                                                                                    Specifies the order applied to the items in the section entries.

                                                                                                    ShortOrder of section entries
                                                                                                    Comments

                                                                                                    Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                    Control0..1
                                                                                                    BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                    (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                                    What order applies to the items in the entry.

                                                                                                    TypeCodeableConcept
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Requirements

                                                                                                    Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    512. Composition.section:family_history_section.entry
                                                                                                    Definition

                                                                                                    A reference to the actual resource from which the narrative in the section is derived.

                                                                                                    Shortentry
                                                                                                    Comments

                                                                                                    If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                    Control0..*
                                                                                                    This element is affected by the following invariants: cmp-2
                                                                                                    TypeReference(Resource)
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                                                    • profile @ resolve()
                                                                                                    • 514. Composition.section:family_history_section.entry:sliceEntry
                                                                                                      Slice NamesliceEntry
                                                                                                      Definition

                                                                                                      A reference to the actual resource from which the narrative in the section is derived.

                                                                                                      ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                                                                                                      Comments

                                                                                                      If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                      Control0..*
                                                                                                      This element is affected by the following invariants: cmp-2
                                                                                                      TypeReference(FamilyMemberHistory)
                                                                                                      Is Modifierfalse
                                                                                                      Summaryfalse
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      516. Composition.section:family_history_section.emptyReason
                                                                                                      Definition

                                                                                                      If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                      ShortWhy the section is empty
                                                                                                      Comments

                                                                                                      The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                      Control0..1
                                                                                                      This element is affected by the following invariants: cmp-2
                                                                                                      BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                                      (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                                                      If a section is empty, why it is empty.

                                                                                                      TypeCodeableConcept
                                                                                                      Is Modifierfalse
                                                                                                      Summaryfalse
                                                                                                      Requirements

                                                                                                      Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      518. Composition.section:family_history_section.section
                                                                                                      Definition

                                                                                                      A nested sub-section within this section.

                                                                                                      ShortNested Section
                                                                                                      Comments

                                                                                                      Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                      Control0..*
                                                                                                      This element is affected by the following invariants: cmp-1
                                                                                                      TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                      Is Modifierfalse
                                                                                                      Summaryfalse
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      520. Composition.section:functional_status_section
                                                                                                      Slice Namefunctional_status_section
                                                                                                      Definition

                                                                                                      The root of the sections that make up the composition.

                                                                                                      ShortFunctional Status Section
                                                                                                      Comments

                                                                                                      Functional Status Section

                                                                                                      Control0..1
                                                                                                      TypeBackboneElement
                                                                                                      Is Modifierfalse
                                                                                                      Summaryfalse
                                                                                                      LabelFunctional Status Section
                                                                                                      Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      522. Composition.section:functional_status_section.id
                                                                                                      Definition

                                                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                      ShortUnique id for inter-element referencing
                                                                                                      Control0..1
                                                                                                      Typestring
                                                                                                      Is Modifierfalse
                                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                      Summaryfalse
                                                                                                      524. Composition.section:functional_status_section.extension
                                                                                                      Definition

                                                                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                      ShortAdditional content defined by implementations
                                                                                                      Comments

                                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                      Control0..*
                                                                                                      TypeExtension
                                                                                                      Is Modifierfalse
                                                                                                      Summaryfalse
                                                                                                      Alternate Namesextensions, user content
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                      526. Composition.section:functional_status_section.modifierExtension
                                                                                                      Definition

                                                                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                                                                      Comments

                                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                      Control0..*
                                                                                                      TypeExtension
                                                                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                      Summarytrue
                                                                                                      Requirements

                                                                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                      Alternate Namesextensions, user content, modifiers
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                      528. Composition.section:functional_status_section.title
                                                                                                      Definition

                                                                                                      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                      Shorttitle
                                                                                                      Comments

                                                                                                      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                      Control1..1
                                                                                                      Typestring
                                                                                                      Is Modifierfalse
                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                      Summaryfalse
                                                                                                      Requirements

                                                                                                      Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                      Alternate Namesheader, label, caption
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      530. Composition.section:functional_status_section.code
                                                                                                      Definition

                                                                                                      A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                      ShortFunctional status
                                                                                                      Comments

                                                                                                      The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                      Control1..1
                                                                                                      BindingFor example codes, see DocumentSectionCodes
                                                                                                      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                                      Classification of a section of a composition/document.

                                                                                                      TypeCodeableConcept
                                                                                                      Is Modifierfalse
                                                                                                      Summaryfalse
                                                                                                      Requirements

                                                                                                      Provides computable standardized labels to topics within the document.

                                                                                                      LabelFunctional status
                                                                                                      Pattern Value{
                                                                                                        "coding" : [{
                                                                                                          "system" : "http://loinc.org",
                                                                                                          "code" : "47420-5"
                                                                                                        }]
                                                                                                      }
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      532. Composition.section:functional_status_section.author
                                                                                                      Definition

                                                                                                      Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                                      ShortWho and/or what authored the section
                                                                                                      Control0..*
                                                                                                      TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                      Is Modifierfalse
                                                                                                      Summaryfalse
                                                                                                      Requirements

                                                                                                      Identifies who is responsible for the content.

                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      534. Composition.section:functional_status_section.focus
                                                                                                      Definition

                                                                                                      The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                      ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                      Comments

                                                                                                      Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                                      Control0..1
                                                                                                      TypeReference(Resource)
                                                                                                      Is Modifierfalse
                                                                                                      Summaryfalse
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      536. Composition.section:functional_status_section.text
                                                                                                      Definition

                                                                                                      A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                                                      Shorttext
                                                                                                      Comments

                                                                                                      Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                      Control1..1
                                                                                                      This element is affected by the following invariants: cmp-1
                                                                                                      TypeNarrative
                                                                                                      Is Modifierfalse
                                                                                                      Summaryfalse
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      538. Composition.section:functional_status_section.mode
                                                                                                      Definition

                                                                                                      How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                      Shortworking | snapshot | changes
                                                                                                      Comments

                                                                                                      This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                      Control0..1
                                                                                                      BindingThe codes SHALL be taken from ListMode
                                                                                                      (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                      The processing mode that applies to this section.

                                                                                                      Typecode
                                                                                                      Is Modifierfalse
                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                      Summaryfalse
                                                                                                      Requirements

                                                                                                      Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      540. Composition.section:functional_status_section.orderedBy
                                                                                                      Definition

                                                                                                      Specifies the order applied to the items in the section entries.

                                                                                                      ShortOrder of section entries
                                                                                                      Comments

                                                                                                      Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                      Control0..1
                                                                                                      BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                      (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                                      What order applies to the items in the entry.

                                                                                                      TypeCodeableConcept
                                                                                                      Is Modifierfalse
                                                                                                      Summaryfalse
                                                                                                      Requirements

                                                                                                      Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      542. Composition.section:functional_status_section.entry
                                                                                                      Definition

                                                                                                      A reference to the actual resource from which the narrative in the section is derived.

                                                                                                      Shortentry
                                                                                                      Comments

                                                                                                      If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                      Control0..*
                                                                                                      This element is affected by the following invariants: cmp-2
                                                                                                      TypeReference(Resource)
                                                                                                      Is Modifierfalse
                                                                                                      Summaryfalse
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                                                      • profile @ resolve()
                                                                                                      • 544. Composition.section:functional_status_section.entry:sliceEntry
                                                                                                        Slice NamesliceEntry
                                                                                                        Definition

                                                                                                        A reference to the actual resource from which the narrative in the section is derived.

                                                                                                        ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                                                                                                        Comments

                                                                                                        If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                        Control0..*
                                                                                                        This element is affected by the following invariants: cmp-2
                                                                                                        TypeReference(Observation)
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        546. Composition.section:functional_status_section.emptyReason
                                                                                                        Definition

                                                                                                        If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                        ShortWhy the section is empty
                                                                                                        Comments

                                                                                                        The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                        Control0..1
                                                                                                        This element is affected by the following invariants: cmp-2
                                                                                                        BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                                        (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                                                        If a section is empty, why it is empty.

                                                                                                        TypeCodeableConcept
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Requirements

                                                                                                        Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        548. Composition.section:functional_status_section.section
                                                                                                        Definition

                                                                                                        A nested sub-section within this section.

                                                                                                        ShortNested Section
                                                                                                        Comments

                                                                                                        Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                        Control0..*
                                                                                                        This element is affected by the following invariants: cmp-1
                                                                                                        TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        550. Composition.section:general_status_section
                                                                                                        Slice Namegeneral_status_section
                                                                                                        Definition

                                                                                                        The root of the sections that make up the composition.

                                                                                                        ShortGeneral Status Section
                                                                                                        Comments

                                                                                                        General Status Section

                                                                                                        Control0..1
                                                                                                        TypeBackboneElement
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        LabelGeneral Status Section
                                                                                                        Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                        cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        552. Composition.section:general_status_section.id
                                                                                                        Definition

                                                                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                        ShortUnique id for inter-element referencing
                                                                                                        Control0..1
                                                                                                        Typestring
                                                                                                        Is Modifierfalse
                                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                        Summaryfalse
                                                                                                        554. Composition.section:general_status_section.extension
                                                                                                        Definition

                                                                                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                        ShortAdditional content defined by implementations
                                                                                                        Comments

                                                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                        Control0..*
                                                                                                        TypeExtension
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Alternate Namesextensions, user content
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                        556. Composition.section:general_status_section.modifierExtension
                                                                                                        Definition

                                                                                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                                                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                                                                        Comments

                                                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                        Control0..*
                                                                                                        TypeExtension
                                                                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                        Summarytrue
                                                                                                        Requirements

                                                                                                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                        Alternate Namesextensions, user content, modifiers
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                        558. Composition.section:general_status_section.title
                                                                                                        Definition

                                                                                                        The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                        Shorttitle
                                                                                                        Comments

                                                                                                        The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                        Control1..1
                                                                                                        Typestring
                                                                                                        Is Modifierfalse
                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                        Summaryfalse
                                                                                                        Requirements

                                                                                                        Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                        Alternate Namesheader, label, caption
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        560. Composition.section:general_status_section.code
                                                                                                        Definition

                                                                                                        A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                        ShortPhysical findings of General status
                                                                                                        Comments

                                                                                                        The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                        If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                        Control1..1
                                                                                                        BindingFor example codes, see DocumentSectionCodes
                                                                                                        (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                                        Classification of a section of a composition/document.

                                                                                                        TypeCodeableConcept
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Requirements

                                                                                                        Provides computable standardized labels to topics within the document.

                                                                                                        LabelPhysical findings of General status
                                                                                                        Pattern Value{
                                                                                                          "coding" : [{
                                                                                                            "system" : "http://loinc.org",
                                                                                                            "code" : "10210-3"
                                                                                                          }]
                                                                                                        }
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        562. Composition.section:general_status_section.author
                                                                                                        Definition

                                                                                                        Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                                        ShortWho and/or what authored the section
                                                                                                        Control0..*
                                                                                                        TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Requirements

                                                                                                        Identifies who is responsible for the content.

                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        564. Composition.section:general_status_section.focus
                                                                                                        Definition

                                                                                                        The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                        ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                        Comments

                                                                                                        Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                                        Control0..1
                                                                                                        TypeReference(Resource)
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        566. Composition.section:general_status_section.text
                                                                                                        Definition

                                                                                                        A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                                                        ShortThis section contains only human readable content
                                                                                                        Comments

                                                                                                        Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                        Control1..1
                                                                                                        This element is affected by the following invariants: cmp-1
                                                                                                        TypeNarrative
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        568. Composition.section:general_status_section.mode
                                                                                                        Definition

                                                                                                        How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                        Shortworking | snapshot | changes
                                                                                                        Comments

                                                                                                        This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                        Control0..1
                                                                                                        BindingThe codes SHALL be taken from ListMode
                                                                                                        (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                        The processing mode that applies to this section.

                                                                                                        Typecode
                                                                                                        Is Modifierfalse
                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                        Summaryfalse
                                                                                                        Requirements

                                                                                                        Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        570. Composition.section:general_status_section.orderedBy
                                                                                                        Definition

                                                                                                        Specifies the order applied to the items in the section entries.

                                                                                                        ShortOrder of section entries
                                                                                                        Comments

                                                                                                        Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                        Control0..1
                                                                                                        BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                        (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                                        What order applies to the items in the entry.

                                                                                                        TypeCodeableConcept
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Requirements

                                                                                                        Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        572. Composition.section:general_status_section.entry
                                                                                                        Definition

                                                                                                        A reference to the actual resource from which the narrative in the section is derived.

                                                                                                        ShortA reference to data that supports this section
                                                                                                        Comments

                                                                                                        If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                        Control0..*
                                                                                                        This element is affected by the following invariants: cmp-2
                                                                                                        TypeReference(Resource)
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        574. Composition.section:general_status_section.emptyReason
                                                                                                        Definition

                                                                                                        If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                        ShortWhy the section is empty
                                                                                                        Comments

                                                                                                        The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                        Control0..1
                                                                                                        This element is affected by the following invariants: cmp-2
                                                                                                        BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                                        (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                                                        If a section is empty, why it is empty.

                                                                                                        TypeCodeableConcept
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Requirements

                                                                                                        Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        576. Composition.section:general_status_section.section
                                                                                                        Definition

                                                                                                        A nested sub-section within this section.

                                                                                                        ShortNested Section
                                                                                                        Comments

                                                                                                        Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                        Control0..*
                                                                                                        This element is affected by the following invariants: cmp-1
                                                                                                        TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        578. Composition.section:past_medical_history_section
                                                                                                        Slice Namepast_medical_history_section
                                                                                                        Definition

                                                                                                        The root of the sections that make up the composition.

                                                                                                        ShortPast Medical History Section
                                                                                                        Comments

                                                                                                        Past Medical History Section

                                                                                                        Control0..1
                                                                                                        TypeBackboneElement
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        LabelPast Medical History Section
                                                                                                        Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                        cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        580. Composition.section:past_medical_history_section.id
                                                                                                        Definition

                                                                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                        ShortUnique id for inter-element referencing
                                                                                                        Control0..1
                                                                                                        Typestring
                                                                                                        Is Modifierfalse
                                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                        Summaryfalse
                                                                                                        582. Composition.section:past_medical_history_section.extension
                                                                                                        Definition

                                                                                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                        ShortAdditional content defined by implementations
                                                                                                        Comments

                                                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                        Control0..*
                                                                                                        TypeExtension
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Alternate Namesextensions, user content
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                        584. Composition.section:past_medical_history_section.modifierExtension
                                                                                                        Definition

                                                                                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                                                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                                                                        Comments

                                                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                        Control0..*
                                                                                                        TypeExtension
                                                                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                        Summarytrue
                                                                                                        Requirements

                                                                                                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                        Alternate Namesextensions, user content, modifiers
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                        586. Composition.section:past_medical_history_section.title
                                                                                                        Definition

                                                                                                        The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                        Shorttitle
                                                                                                        Comments

                                                                                                        The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                        Control1..1
                                                                                                        Typestring
                                                                                                        Is Modifierfalse
                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                        Summaryfalse
                                                                                                        Requirements

                                                                                                        Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                        Alternate Namesheader, label, caption
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        588. Composition.section:past_medical_history_section.code
                                                                                                        Definition

                                                                                                        A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                        ShortPast Medical History
                                                                                                        Comments

                                                                                                        The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                        If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                        Control1..1
                                                                                                        BindingFor example codes, see DocumentSectionCodes
                                                                                                        (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                                        Classification of a section of a composition/document.

                                                                                                        TypeCodeableConcept
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Requirements

                                                                                                        Provides computable standardized labels to topics within the document.

                                                                                                        LabelPast Medical History
                                                                                                        Pattern Value{
                                                                                                          "coding" : [{
                                                                                                            "system" : "http://loinc.org",
                                                                                                            "code" : "11348-0"
                                                                                                          }]
                                                                                                        }
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        590. Composition.section:past_medical_history_section.author
                                                                                                        Definition

                                                                                                        Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                                        ShortWho and/or what authored the section
                                                                                                        Control0..*
                                                                                                        TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Requirements

                                                                                                        Identifies who is responsible for the content.

                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        592. Composition.section:past_medical_history_section.focus
                                                                                                        Definition

                                                                                                        The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                        ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                        Comments

                                                                                                        Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                                        Control0..1
                                                                                                        TypeReference(Resource)
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        594. Composition.section:past_medical_history_section.text
                                                                                                        Definition

                                                                                                        A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                                                        Shorttext
                                                                                                        Comments

                                                                                                        Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                        Control1..1
                                                                                                        This element is affected by the following invariants: cmp-1
                                                                                                        TypeNarrative
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        596. Composition.section:past_medical_history_section.mode
                                                                                                        Definition

                                                                                                        How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                        Shortworking | snapshot | changes
                                                                                                        Comments

                                                                                                        This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                        Control0..1
                                                                                                        BindingThe codes SHALL be taken from ListMode
                                                                                                        (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                        The processing mode that applies to this section.

                                                                                                        Typecode
                                                                                                        Is Modifierfalse
                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                        Summaryfalse
                                                                                                        Requirements

                                                                                                        Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        598. Composition.section:past_medical_history_section.orderedBy
                                                                                                        Definition

                                                                                                        Specifies the order applied to the items in the section entries.

                                                                                                        ShortOrder of section entries
                                                                                                        Comments

                                                                                                        Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                        Control0..1
                                                                                                        BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                        (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                                        What order applies to the items in the entry.

                                                                                                        TypeCodeableConcept
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Requirements

                                                                                                        Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        600. Composition.section:past_medical_history_section.entry
                                                                                                        Definition

                                                                                                        A reference to the actual resource from which the narrative in the section is derived.

                                                                                                        Shortentry
                                                                                                        Comments

                                                                                                        If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                        Control0..*
                                                                                                        This element is affected by the following invariants: cmp-2
                                                                                                        TypeReference(Resource)
                                                                                                        Is Modifierfalse
                                                                                                        Summaryfalse
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                                                        • profile @ resolve()
                                                                                                        • 602. Composition.section:past_medical_history_section.entry:sliceEntry
                                                                                                          Slice NamesliceEntry
                                                                                                          Definition

                                                                                                          A reference to the actual resource from which the narrative in the section is derived.

                                                                                                          ShortA reference to data that supports this section
                                                                                                          Comments

                                                                                                          If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                          Control0..*
                                                                                                          This element is affected by the following invariants: cmp-2
                                                                                                          TypeReference(US Core Condition Profile)
                                                                                                          Is Modifierfalse
                                                                                                          Summaryfalse
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          604. Composition.section:past_medical_history_section.emptyReason
                                                                                                          Definition

                                                                                                          If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                          ShortWhy the section is empty
                                                                                                          Comments

                                                                                                          The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                          Control0..1
                                                                                                          This element is affected by the following invariants: cmp-2
                                                                                                          BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                                          (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                                                          If a section is empty, why it is empty.

                                                                                                          TypeCodeableConcept
                                                                                                          Is Modifierfalse
                                                                                                          Summaryfalse
                                                                                                          Requirements

                                                                                                          Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          606. Composition.section:past_medical_history_section.section
                                                                                                          Definition

                                                                                                          A nested sub-section within this section.

                                                                                                          ShortNested Section
                                                                                                          Comments

                                                                                                          Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                          Control0..*
                                                                                                          This element is affected by the following invariants: cmp-1
                                                                                                          TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                          Is Modifierfalse
                                                                                                          Summaryfalse
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          608. Composition.section:immunizations_section
                                                                                                          Slice Nameimmunizations_section
                                                                                                          Definition

                                                                                                          The root of the sections that make up the composition.

                                                                                                          ShortImmunizations Section
                                                                                                          Comments

                                                                                                          Immunizations Section

                                                                                                          Control0..1
                                                                                                          TypeBackboneElement
                                                                                                          Is Modifierfalse
                                                                                                          Summaryfalse
                                                                                                          LabelImmunizations Section
                                                                                                          Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          610. Composition.section:immunizations_section.id
                                                                                                          Definition

                                                                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                          ShortUnique id for inter-element referencing
                                                                                                          Control0..1
                                                                                                          Typestring
                                                                                                          Is Modifierfalse
                                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                          Summaryfalse
                                                                                                          612. Composition.section:immunizations_section.extension
                                                                                                          Definition

                                                                                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                          ShortAdditional content defined by implementations
                                                                                                          Comments

                                                                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                          Control0..*
                                                                                                          TypeExtension
                                                                                                          Is Modifierfalse
                                                                                                          Summaryfalse
                                                                                                          Alternate Namesextensions, user content
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                          614. Composition.section:immunizations_section.modifierExtension
                                                                                                          Definition

                                                                                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                                                                          Comments

                                                                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                          Control0..*
                                                                                                          TypeExtension
                                                                                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                          Summarytrue
                                                                                                          Requirements

                                                                                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                          Alternate Namesextensions, user content, modifiers
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                          616. Composition.section:immunizations_section.title
                                                                                                          Definition

                                                                                                          The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                          Shorttitle
                                                                                                          Comments

                                                                                                          The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                          Control1..1
                                                                                                          Typestring
                                                                                                          Is Modifierfalse
                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                          Summaryfalse
                                                                                                          Requirements

                                                                                                          Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                          Alternate Namesheader, label, caption
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          618. Composition.section:immunizations_section.code
                                                                                                          Definition

                                                                                                          A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                          ShortHistory of immunization
                                                                                                          Comments

                                                                                                          The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                          If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                          Control1..1
                                                                                                          BindingFor example codes, see DocumentSectionCodes
                                                                                                          (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                                          Classification of a section of a composition/document.

                                                                                                          TypeCodeableConcept
                                                                                                          Is Modifierfalse
                                                                                                          Summaryfalse
                                                                                                          Requirements

                                                                                                          Provides computable standardized labels to topics within the document.

                                                                                                          LabelHistory of immunization
                                                                                                          Pattern Value{
                                                                                                            "coding" : [{
                                                                                                              "system" : "http://loinc.org",
                                                                                                              "code" : "11369-6"
                                                                                                            }]
                                                                                                          }
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          620. Composition.section:immunizations_section.author
                                                                                                          Definition

                                                                                                          Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                                          ShortWho and/or what authored the section
                                                                                                          Control0..*
                                                                                                          TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                          Is Modifierfalse
                                                                                                          Summaryfalse
                                                                                                          Requirements

                                                                                                          Identifies who is responsible for the content.

                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          622. Composition.section:immunizations_section.focus
                                                                                                          Definition

                                                                                                          The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                          ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                          Comments

                                                                                                          Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                                          Control0..1
                                                                                                          TypeReference(Resource)
                                                                                                          Is Modifierfalse
                                                                                                          Summaryfalse
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          624. Composition.section:immunizations_section.text
                                                                                                          Definition

                                                                                                          A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                                                          Shorttext
                                                                                                          Comments

                                                                                                          Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                          Control1..1
                                                                                                          This element is affected by the following invariants: cmp-1
                                                                                                          TypeNarrative
                                                                                                          Is Modifierfalse
                                                                                                          Summaryfalse
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          626. Composition.section:immunizations_section.mode
                                                                                                          Definition

                                                                                                          How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                          Shortworking | snapshot | changes
                                                                                                          Comments

                                                                                                          This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                          Control0..1
                                                                                                          BindingThe codes SHALL be taken from ListMode
                                                                                                          (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                          The processing mode that applies to this section.

                                                                                                          Typecode
                                                                                                          Is Modifierfalse
                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                          Summaryfalse
                                                                                                          Requirements

                                                                                                          Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          628. Composition.section:immunizations_section.orderedBy
                                                                                                          Definition

                                                                                                          Specifies the order applied to the items in the section entries.

                                                                                                          ShortOrder of section entries
                                                                                                          Comments

                                                                                                          Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                          Control0..1
                                                                                                          BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                          (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                                          What order applies to the items in the entry.

                                                                                                          TypeCodeableConcept
                                                                                                          Is Modifierfalse
                                                                                                          Summaryfalse
                                                                                                          Requirements

                                                                                                          Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          630. Composition.section:immunizations_section.entry
                                                                                                          Definition

                                                                                                          A reference to the actual resource from which the narrative in the section is derived.

                                                                                                          Shortentry
                                                                                                          Comments

                                                                                                          If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                          Control0..*
                                                                                                          This element is affected by the following invariants: cmp-2
                                                                                                          TypeReference(Resource)
                                                                                                          Is Modifierfalse
                                                                                                          Summaryfalse
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                                                          • profile @ resolve()
                                                                                                          • 632. Composition.section:immunizations_section.entry:sliceEntry
                                                                                                            Slice NamesliceEntry
                                                                                                            Definition

                                                                                                            A reference to the actual resource from which the narrative in the section is derived.

                                                                                                            ShortA reference to data that supports this section
                                                                                                            Comments

                                                                                                            If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                            Control0..*
                                                                                                            This element is affected by the following invariants: cmp-2
                                                                                                            TypeReference(US Core Immunization Profile)
                                                                                                            Is Modifierfalse
                                                                                                            Summaryfalse
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            634. Composition.section:immunizations_section.emptyReason
                                                                                                            Definition

                                                                                                            If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                            ShortWhy the section is empty
                                                                                                            Comments

                                                                                                            The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                            Control0..1
                                                                                                            This element is affected by the following invariants: cmp-2
                                                                                                            BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                                            (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                                                            If a section is empty, why it is empty.

                                                                                                            TypeCodeableConcept
                                                                                                            Is Modifierfalse
                                                                                                            Summaryfalse
                                                                                                            Requirements

                                                                                                            Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            636. Composition.section:immunizations_section.section
                                                                                                            Definition

                                                                                                            A nested sub-section within this section.

                                                                                                            ShortNested Section
                                                                                                            Comments

                                                                                                            Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                            Control0..*
                                                                                                            This element is affected by the following invariants: cmp-1
                                                                                                            TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                            Is Modifierfalse
                                                                                                            Summaryfalse
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            638. Composition.section:medical_equipment_section
                                                                                                            Slice Namemedical_equipment_section
                                                                                                            Definition

                                                                                                            The root of the sections that make up the composition.

                                                                                                            ShortMedical Equipment Section
                                                                                                            Comments

                                                                                                            Medical Equipment Section

                                                                                                            Control0..1
                                                                                                            TypeBackboneElement
                                                                                                            Is Modifierfalse
                                                                                                            Summaryfalse
                                                                                                            LabelMedical Equipment Section
                                                                                                            Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            640. Composition.section:medical_equipment_section.id
                                                                                                            Definition

                                                                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                            ShortUnique id for inter-element referencing
                                                                                                            Control0..1
                                                                                                            Typestring
                                                                                                            Is Modifierfalse
                                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                            Summaryfalse
                                                                                                            642. Composition.section:medical_equipment_section.extension
                                                                                                            Definition

                                                                                                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                            ShortAdditional content defined by implementations
                                                                                                            Comments

                                                                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                            Control0..*
                                                                                                            TypeExtension
                                                                                                            Is Modifierfalse
                                                                                                            Summaryfalse
                                                                                                            Alternate Namesextensions, user content
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                            644. Composition.section:medical_equipment_section.modifierExtension
                                                                                                            Definition

                                                                                                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                                                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                                                                            Comments

                                                                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                            Control0..*
                                                                                                            TypeExtension
                                                                                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                            Summarytrue
                                                                                                            Requirements

                                                                                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                            Alternate Namesextensions, user content, modifiers
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                            646. Composition.section:medical_equipment_section.title
                                                                                                            Definition

                                                                                                            The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                            Shorttitle
                                                                                                            Comments

                                                                                                            The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                            Control1..1
                                                                                                            Typestring
                                                                                                            Is Modifierfalse
                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                            Summaryfalse
                                                                                                            Requirements

                                                                                                            Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                            Alternate Namesheader, label, caption
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            648. Composition.section:medical_equipment_section.code
                                                                                                            Definition

                                                                                                            A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                            ShortHistory of medical device use
                                                                                                            Comments

                                                                                                            The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                            If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                            Control1..1
                                                                                                            BindingFor example codes, see DocumentSectionCodes
                                                                                                            (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                                            Classification of a section of a composition/document.

                                                                                                            TypeCodeableConcept
                                                                                                            Is Modifierfalse
                                                                                                            Summaryfalse
                                                                                                            Requirements

                                                                                                            Provides computable standardized labels to topics within the document.

                                                                                                            LabelHistory of medical device use
                                                                                                            Pattern Value{
                                                                                                              "coding" : [{
                                                                                                                "system" : "http://loinc.org",
                                                                                                                "code" : "46264-8"
                                                                                                              }]
                                                                                                            }
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            650. Composition.section:medical_equipment_section.author
                                                                                                            Definition

                                                                                                            Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                                            ShortWho and/or what authored the section
                                                                                                            Control0..*
                                                                                                            TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                            Is Modifierfalse
                                                                                                            Summaryfalse
                                                                                                            Requirements

                                                                                                            Identifies who is responsible for the content.

                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            652. Composition.section:medical_equipment_section.focus
                                                                                                            Definition

                                                                                                            The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                            ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                            Comments

                                                                                                            Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                                            Control0..1
                                                                                                            TypeReference(Resource)
                                                                                                            Is Modifierfalse
                                                                                                            Summaryfalse
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            654. Composition.section:medical_equipment_section.text
                                                                                                            Definition

                                                                                                            A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                                                            Shorttext
                                                                                                            Comments

                                                                                                            Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                            Control1..1
                                                                                                            This element is affected by the following invariants: cmp-1
                                                                                                            TypeNarrative
                                                                                                            Is Modifierfalse
                                                                                                            Summaryfalse
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            656. Composition.section:medical_equipment_section.mode
                                                                                                            Definition

                                                                                                            How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                            Shortworking | snapshot | changes
                                                                                                            Comments

                                                                                                            This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                            Control0..1
                                                                                                            BindingThe codes SHALL be taken from ListMode
                                                                                                            (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                            The processing mode that applies to this section.

                                                                                                            Typecode
                                                                                                            Is Modifierfalse
                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                            Summaryfalse
                                                                                                            Requirements

                                                                                                            Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            658. Composition.section:medical_equipment_section.orderedBy
                                                                                                            Definition

                                                                                                            Specifies the order applied to the items in the section entries.

                                                                                                            ShortOrder of section entries
                                                                                                            Comments

                                                                                                            Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                            Control0..1
                                                                                                            BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                            (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                                            What order applies to the items in the entry.

                                                                                                            TypeCodeableConcept
                                                                                                            Is Modifierfalse
                                                                                                            Summaryfalse
                                                                                                            Requirements

                                                                                                            Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            660. Composition.section:medical_equipment_section.entry
                                                                                                            Definition

                                                                                                            A reference to the actual resource from which the narrative in the section is derived.

                                                                                                            Shortentry
                                                                                                            Comments

                                                                                                            If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                            Control0..*
                                                                                                            This element is affected by the following invariants: cmp-2
                                                                                                            TypeReference(Resource)
                                                                                                            Is Modifierfalse
                                                                                                            Summaryfalse
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                                                            • profile @ resolve()
                                                                                                            • 662. Composition.section:medical_equipment_section.entry:medical_equipment_entry
                                                                                                              Slice Namemedical_equipment_entry
                                                                                                              Definition

                                                                                                              A reference to the actual resource from which the narrative in the section is derived.

                                                                                                              ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                                                                                                              Comments

                                                                                                              If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                              Control0..*
                                                                                                              This element is affected by the following invariants: cmp-2
                                                                                                              TypeReference(Device, US Core Procedure Profile)
                                                                                                              Is Modifierfalse
                                                                                                              Must Supporttrue
                                                                                                              Must Support TypesNo must-support rules about the choice of types/profiles
                                                                                                              Summaryfalse
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              664. Composition.section:medical_equipment_section.emptyReason
                                                                                                              Definition

                                                                                                              If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                              ShortWhy the section is empty
                                                                                                              Comments

                                                                                                              The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                              Control0..1
                                                                                                              This element is affected by the following invariants: cmp-2
                                                                                                              BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                                              (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                                                              If a section is empty, why it is empty.

                                                                                                              TypeCodeableConcept
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Requirements

                                                                                                              Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              666. Composition.section:medical_equipment_section.section
                                                                                                              Definition

                                                                                                              A nested sub-section within this section.

                                                                                                              ShortNested Section
                                                                                                              Comments

                                                                                                              Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                              Control0..*
                                                                                                              This element is affected by the following invariants: cmp-1
                                                                                                              TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              668. Composition.section:mental_status_section
                                                                                                              Slice Namemental_status_section
                                                                                                              Definition

                                                                                                              The root of the sections that make up the composition.

                                                                                                              ShortMental Status Section
                                                                                                              Comments

                                                                                                              Mental Status Section

                                                                                                              Control0..1
                                                                                                              TypeBackboneElement
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              LabelMental Status Section
                                                                                                              Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              670. Composition.section:mental_status_section.id
                                                                                                              Definition

                                                                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                              ShortUnique id for inter-element referencing
                                                                                                              Control0..1
                                                                                                              Typestring
                                                                                                              Is Modifierfalse
                                                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                              Summaryfalse
                                                                                                              672. Composition.section:mental_status_section.extension
                                                                                                              Definition

                                                                                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                              ShortAdditional content defined by implementations
                                                                                                              Comments

                                                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                              Control0..*
                                                                                                              TypeExtension
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Alternate Namesextensions, user content
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                              674. Composition.section:mental_status_section.modifierExtension
                                                                                                              Definition

                                                                                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                                                                              Comments

                                                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                              Control0..*
                                                                                                              TypeExtension
                                                                                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                              Summarytrue
                                                                                                              Requirements

                                                                                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                              Alternate Namesextensions, user content, modifiers
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                              676. Composition.section:mental_status_section.title
                                                                                                              Definition

                                                                                                              The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                              Shorttitle
                                                                                                              Comments

                                                                                                              The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                              Control1..1
                                                                                                              Typestring
                                                                                                              Is Modifierfalse
                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                              Summaryfalse
                                                                                                              Requirements

                                                                                                              Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                              Alternate Namesheader, label, caption
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              678. Composition.section:mental_status_section.code
                                                                                                              Definition

                                                                                                              A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                              ShortMental status
                                                                                                              Comments

                                                                                                              The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                              If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                              Control1..1
                                                                                                              BindingFor example codes, see DocumentSectionCodes
                                                                                                              (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                                              Classification of a section of a composition/document.

                                                                                                              TypeCodeableConcept
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Requirements

                                                                                                              Provides computable standardized labels to topics within the document.

                                                                                                              LabelMental status
                                                                                                              Pattern Value{
                                                                                                                "coding" : [{
                                                                                                                  "system" : "http://loinc.org",
                                                                                                                  "code" : "10190-7"
                                                                                                                }]
                                                                                                              }
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              680. Composition.section:mental_status_section.author
                                                                                                              Definition

                                                                                                              Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                                              ShortWho and/or what authored the section
                                                                                                              Control0..*
                                                                                                              TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Requirements

                                                                                                              Identifies who is responsible for the content.

                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              682. Composition.section:mental_status_section.focus
                                                                                                              Definition

                                                                                                              The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                              ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                              Comments

                                                                                                              Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                                              Control0..1
                                                                                                              TypeReference(Resource)
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              684. Composition.section:mental_status_section.text
                                                                                                              Definition

                                                                                                              A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                                                              Shorttext
                                                                                                              Comments

                                                                                                              Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                              Control1..1
                                                                                                              This element is affected by the following invariants: cmp-1
                                                                                                              TypeNarrative
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              686. Composition.section:mental_status_section.mode
                                                                                                              Definition

                                                                                                              How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                              Shortworking | snapshot | changes
                                                                                                              Comments

                                                                                                              This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                              Control0..1
                                                                                                              BindingThe codes SHALL be taken from ListMode
                                                                                                              (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                              The processing mode that applies to this section.

                                                                                                              Typecode
                                                                                                              Is Modifierfalse
                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                              Summaryfalse
                                                                                                              Requirements

                                                                                                              Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              688. Composition.section:mental_status_section.orderedBy
                                                                                                              Definition

                                                                                                              Specifies the order applied to the items in the section entries.

                                                                                                              ShortOrder of section entries
                                                                                                              Comments

                                                                                                              Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                              Control0..1
                                                                                                              BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                              (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                                              What order applies to the items in the entry.

                                                                                                              TypeCodeableConcept
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Requirements

                                                                                                              Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              690. Composition.section:mental_status_section.entry
                                                                                                              Definition

                                                                                                              A reference to the actual resource from which the narrative in the section is derived.

                                                                                                              Shortentry
                                                                                                              Comments

                                                                                                              If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                              Control0..*
                                                                                                              This element is affected by the following invariants: cmp-2
                                                                                                              TypeReference(Resource)
                                                                                                              Is Modifierfalse
                                                                                                              Summaryfalse
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                                                              • profile @ resolve()
                                                                                                              • 692. Composition.section:mental_status_section.entry:sliceEntry
                                                                                                                Slice NamesliceEntry
                                                                                                                Definition

                                                                                                                A reference to the actual resource from which the narrative in the section is derived.

                                                                                                                ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                                                                                                                Comments

                                                                                                                If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                                Control0..*
                                                                                                                This element is affected by the following invariants: cmp-2
                                                                                                                TypeReference(Observation)
                                                                                                                Is Modifierfalse
                                                                                                                Summaryfalse
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                694. Composition.section:mental_status_section.emptyReason
                                                                                                                Definition

                                                                                                                If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                                ShortWhy the section is empty
                                                                                                                Comments

                                                                                                                The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                                Control0..1
                                                                                                                This element is affected by the following invariants: cmp-2
                                                                                                                BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                                                (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                                                                If a section is empty, why it is empty.

                                                                                                                TypeCodeableConcept
                                                                                                                Is Modifierfalse
                                                                                                                Summaryfalse
                                                                                                                Requirements

                                                                                                                Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                696. Composition.section:mental_status_section.section
                                                                                                                Definition

                                                                                                                A nested sub-section within this section.

                                                                                                                ShortNested Section
                                                                                                                Comments

                                                                                                                Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                                Control0..*
                                                                                                                This element is affected by the following invariants: cmp-1
                                                                                                                TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                                Is Modifierfalse
                                                                                                                Summaryfalse
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                698. Composition.section:nutrition_section
                                                                                                                Slice Namenutrition_section
                                                                                                                Definition

                                                                                                                The root of the sections that make up the composition.

                                                                                                                ShortNutrition Section
                                                                                                                Comments

                                                                                                                Nutrition Section

                                                                                                                Control0..1
                                                                                                                TypeBackboneElement
                                                                                                                Is Modifierfalse
                                                                                                                Summaryfalse
                                                                                                                LabelNutrition Section
                                                                                                                Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                                cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                                ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                700. Composition.section:nutrition_section.id
                                                                                                                Definition

                                                                                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                ShortUnique id for inter-element referencing
                                                                                                                Control0..1
                                                                                                                Typestring
                                                                                                                Is Modifierfalse
                                                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                Summaryfalse
                                                                                                                702. Composition.section:nutrition_section.extension
                                                                                                                Definition

                                                                                                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                ShortAdditional content defined by implementations
                                                                                                                Comments

                                                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                Control0..*
                                                                                                                TypeExtension
                                                                                                                Is Modifierfalse
                                                                                                                Summaryfalse
                                                                                                                Alternate Namesextensions, user content
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                704. Composition.section:nutrition_section.modifierExtension
                                                                                                                Definition

                                                                                                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                                                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                Comments

                                                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                Control0..*
                                                                                                                TypeExtension
                                                                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                Summarytrue
                                                                                                                Requirements

                                                                                                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                Alternate Namesextensions, user content, modifiers
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                706. Composition.section:nutrition_section.title
                                                                                                                Definition

                                                                                                                The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                                Shorttitle
                                                                                                                Comments

                                                                                                                The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                                Control1..1
                                                                                                                Typestring
                                                                                                                Is Modifierfalse
                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                Summaryfalse
                                                                                                                Requirements

                                                                                                                Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                                Alternate Namesheader, label, caption
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                708. Composition.section:nutrition_section.code
                                                                                                                Definition

                                                                                                                A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                                ShortDiet and nutrition
                                                                                                                Comments

                                                                                                                The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                                If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                                Control1..1
                                                                                                                BindingFor example codes, see DocumentSectionCodes
                                                                                                                (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                                                Classification of a section of a composition/document.

                                                                                                                TypeCodeableConcept
                                                                                                                Is Modifierfalse
                                                                                                                Summaryfalse
                                                                                                                Requirements

                                                                                                                Provides computable standardized labels to topics within the document.

                                                                                                                LabelDiet and nutrition
                                                                                                                Pattern Value{
                                                                                                                  "coding" : [{
                                                                                                                    "system" : "http://loinc.org",
                                                                                                                    "code" : "61144-2"
                                                                                                                  }]
                                                                                                                }
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                710. Composition.section:nutrition_section.author
                                                                                                                Definition

                                                                                                                Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                                                ShortWho and/or what authored the section
                                                                                                                Control0..*
                                                                                                                TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                                Is Modifierfalse
                                                                                                                Summaryfalse
                                                                                                                Requirements

                                                                                                                Identifies who is responsible for the content.

                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                712. Composition.section:nutrition_section.focus
                                                                                                                Definition

                                                                                                                The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                                ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                                Comments

                                                                                                                Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                                                Control0..1
                                                                                                                TypeReference(Resource)
                                                                                                                Is Modifierfalse
                                                                                                                Summaryfalse
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                714. Composition.section:nutrition_section.text
                                                                                                                Definition

                                                                                                                A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                                                                Shorttext
                                                                                                                Comments

                                                                                                                Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                                Control1..1
                                                                                                                This element is affected by the following invariants: cmp-1
                                                                                                                TypeNarrative
                                                                                                                Is Modifierfalse
                                                                                                                Summaryfalse
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                716. Composition.section:nutrition_section.mode
                                                                                                                Definition

                                                                                                                How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                                Shortworking | snapshot | changes
                                                                                                                Comments

                                                                                                                This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                                Control0..1
                                                                                                                BindingThe codes SHALL be taken from ListMode
                                                                                                                (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                                The processing mode that applies to this section.

                                                                                                                Typecode
                                                                                                                Is Modifierfalse
                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                Summaryfalse
                                                                                                                Requirements

                                                                                                                Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                718. Composition.section:nutrition_section.orderedBy
                                                                                                                Definition

                                                                                                                Specifies the order applied to the items in the section entries.

                                                                                                                ShortOrder of section entries
                                                                                                                Comments

                                                                                                                Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                                Control0..1
                                                                                                                BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                                (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                                                What order applies to the items in the entry.

                                                                                                                TypeCodeableConcept
                                                                                                                Is Modifierfalse
                                                                                                                Summaryfalse
                                                                                                                Requirements

                                                                                                                Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                720. Composition.section:nutrition_section.entry
                                                                                                                Definition

                                                                                                                A reference to the actual resource from which the narrative in the section is derived.

                                                                                                                Shortentry
                                                                                                                Comments

                                                                                                                If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                                Control0..*
                                                                                                                This element is affected by the following invariants: cmp-2
                                                                                                                TypeReference(Resource)
                                                                                                                Is Modifierfalse
                                                                                                                Summaryfalse
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                                                                • profile @ resolve()
                                                                                                                • 722. Composition.section:nutrition_section.entry:sliceEntry
                                                                                                                  Slice NamesliceEntry
                                                                                                                  Definition

                                                                                                                  A reference to the actual resource from which the narrative in the section is derived.

                                                                                                                  ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                                                                                                                  Comments

                                                                                                                  If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                                  Control0..*
                                                                                                                  This element is affected by the following invariants: cmp-2
                                                                                                                  TypeReference(NutritionOrder, ClinicalImpression)
                                                                                                                  Is Modifierfalse
                                                                                                                  Summaryfalse
                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  724. Composition.section:nutrition_section.emptyReason
                                                                                                                  Definition

                                                                                                                  If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                                  ShortWhy the section is empty
                                                                                                                  Comments

                                                                                                                  The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                                  Control0..1
                                                                                                                  This element is affected by the following invariants: cmp-2
                                                                                                                  BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                                                  (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                                                                  If a section is empty, why it is empty.

                                                                                                                  TypeCodeableConcept
                                                                                                                  Is Modifierfalse
                                                                                                                  Summaryfalse
                                                                                                                  Requirements

                                                                                                                  Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  726. Composition.section:nutrition_section.section
                                                                                                                  Definition

                                                                                                                  A nested sub-section within this section.

                                                                                                                  ShortNested Section
                                                                                                                  Comments

                                                                                                                  Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                                  Control0..*
                                                                                                                  This element is affected by the following invariants: cmp-1
                                                                                                                  TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                                  Is Modifierfalse
                                                                                                                  Summaryfalse
                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  728. Composition.section:plan_of_treatment_section
                                                                                                                  Slice Nameplan_of_treatment_section
                                                                                                                  Definition

                                                                                                                  The root of the sections that make up the composition.

                                                                                                                  ShortPlan of Treatment Section
                                                                                                                  Comments

                                                                                                                  Plan of Treatment Section

                                                                                                                  Control0..1
                                                                                                                  TypeBackboneElement
                                                                                                                  Is Modifierfalse
                                                                                                                  Summaryfalse
                                                                                                                  LabelPlan of Treatment Section
                                                                                                                  Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                                  cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                                  ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  730. Composition.section:plan_of_treatment_section.id
                                                                                                                  Definition

                                                                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                  ShortUnique id for inter-element referencing
                                                                                                                  Control0..1
                                                                                                                  Typestring
                                                                                                                  Is Modifierfalse
                                                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                  Summaryfalse
                                                                                                                  732. Composition.section:plan_of_treatment_section.extension
                                                                                                                  Definition

                                                                                                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                  ShortAdditional content defined by implementations
                                                                                                                  Comments

                                                                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                  Control0..*
                                                                                                                  TypeExtension
                                                                                                                  Is Modifierfalse
                                                                                                                  Summaryfalse
                                                                                                                  Alternate Namesextensions, user content
                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                  734. Composition.section:plan_of_treatment_section.modifierExtension
                                                                                                                  Definition

                                                                                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                                                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                  Comments

                                                                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                  Control0..*
                                                                                                                  TypeExtension
                                                                                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                  Summarytrue
                                                                                                                  Requirements

                                                                                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                  Alternate Namesextensions, user content, modifiers
                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                  736. Composition.section:plan_of_treatment_section.title
                                                                                                                  Definition

                                                                                                                  The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                                  Shorttitle
                                                                                                                  Comments

                                                                                                                  The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                                  Control1..1
                                                                                                                  Typestring
                                                                                                                  Is Modifierfalse
                                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                  Summaryfalse
                                                                                                                  Requirements

                                                                                                                  Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                                  Alternate Namesheader, label, caption
                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  738. Composition.section:plan_of_treatment_section.code
                                                                                                                  Definition

                                                                                                                  A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                                  ShortPlan of treatment
                                                                                                                  Comments

                                                                                                                  The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                                  If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                                  Control1..1
                                                                                                                  BindingFor example codes, see DocumentSectionCodes
                                                                                                                  (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                                                  Classification of a section of a composition/document.

                                                                                                                  TypeCodeableConcept
                                                                                                                  Is Modifierfalse
                                                                                                                  Summaryfalse
                                                                                                                  Requirements

                                                                                                                  Provides computable standardized labels to topics within the document.

                                                                                                                  LabelPlan of treatment
                                                                                                                  Pattern Value{
                                                                                                                    "coding" : [{
                                                                                                                      "system" : "http://loinc.org",
                                                                                                                      "code" : "18776-5"
                                                                                                                    }]
                                                                                                                  }
                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  740. Composition.section:plan_of_treatment_section.author
                                                                                                                  Definition

                                                                                                                  Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                                                  ShortWho and/or what authored the section
                                                                                                                  Control0..*
                                                                                                                  TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                                  Is Modifierfalse
                                                                                                                  Summaryfalse
                                                                                                                  Requirements

                                                                                                                  Identifies who is responsible for the content.

                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  742. Composition.section:plan_of_treatment_section.focus
                                                                                                                  Definition

                                                                                                                  The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                                  ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                                  Comments

                                                                                                                  Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                                                  Control0..1
                                                                                                                  TypeReference(Resource)
                                                                                                                  Is Modifierfalse
                                                                                                                  Summaryfalse
                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  744. Composition.section:plan_of_treatment_section.text
                                                                                                                  Definition

                                                                                                                  A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                                                                  Shorttext
                                                                                                                  Comments

                                                                                                                  Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                                  Control1..1
                                                                                                                  This element is affected by the following invariants: cmp-1
                                                                                                                  TypeNarrative
                                                                                                                  Is Modifierfalse
                                                                                                                  Summaryfalse
                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  746. Composition.section:plan_of_treatment_section.mode
                                                                                                                  Definition

                                                                                                                  How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                                  Shortworking | snapshot | changes
                                                                                                                  Comments

                                                                                                                  This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                                  Control0..1
                                                                                                                  BindingThe codes SHALL be taken from ListMode
                                                                                                                  (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                                  The processing mode that applies to this section.

                                                                                                                  Typecode
                                                                                                                  Is Modifierfalse
                                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                  Summaryfalse
                                                                                                                  Requirements

                                                                                                                  Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  748. Composition.section:plan_of_treatment_section.orderedBy
                                                                                                                  Definition

                                                                                                                  Specifies the order applied to the items in the section entries.

                                                                                                                  ShortOrder of section entries
                                                                                                                  Comments

                                                                                                                  Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                                  Control0..1
                                                                                                                  BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                                  (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                                                  What order applies to the items in the entry.

                                                                                                                  TypeCodeableConcept
                                                                                                                  Is Modifierfalse
                                                                                                                  Summaryfalse
                                                                                                                  Requirements

                                                                                                                  Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  750. Composition.section:plan_of_treatment_section.entry
                                                                                                                  Definition

                                                                                                                  A reference to the actual resource from which the narrative in the section is derived.

                                                                                                                  Shortentry
                                                                                                                  Comments

                                                                                                                  If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                                  Control0..*
                                                                                                                  This element is affected by the following invariants: cmp-2
                                                                                                                  TypeReference(Resource)
                                                                                                                  Is Modifierfalse
                                                                                                                  Summaryfalse
                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                                                                  • profile @ resolve()
                                                                                                                  • 752. Composition.section:plan_of_treatment_section.entry:sliceEntry
                                                                                                                    Slice NamesliceEntry
                                                                                                                    Definition

                                                                                                                    A reference to the actual resource from which the narrative in the section is derived.

                                                                                                                    ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                                                                                                                    Comments

                                                                                                                    If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                                    Control0..*
                                                                                                                    This element is affected by the following invariants: cmp-2
                                                                                                                    TypeReference(US Core Goal Profile, US Core MedicationRequest Profile, US Core Encounter Profile, Communication, Appointment, CommunicationRequest, DeviceRequest, NutritionOrder, Task, ServiceRequest, VisionPrescription, RequestGroup)
                                                                                                                    Is Modifierfalse
                                                                                                                    Summaryfalse
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    754. Composition.section:plan_of_treatment_section.emptyReason
                                                                                                                    Definition

                                                                                                                    If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                                    ShortWhy the section is empty
                                                                                                                    Comments

                                                                                                                    The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                                    Control0..1
                                                                                                                    This element is affected by the following invariants: cmp-2
                                                                                                                    BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                                                    (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                                                                    If a section is empty, why it is empty.

                                                                                                                    TypeCodeableConcept
                                                                                                                    Is Modifierfalse
                                                                                                                    Summaryfalse
                                                                                                                    Requirements

                                                                                                                    Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    756. Composition.section:plan_of_treatment_section.section
                                                                                                                    Definition

                                                                                                                    A nested sub-section within this section.

                                                                                                                    ShortNested Section
                                                                                                                    Comments

                                                                                                                    Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                                    Control0..*
                                                                                                                    This element is affected by the following invariants: cmp-1
                                                                                                                    TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                                    Is Modifierfalse
                                                                                                                    Summaryfalse
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    758. Composition.section:procedures_section
                                                                                                                    Slice Nameprocedures_section
                                                                                                                    Definition

                                                                                                                    The root of the sections that make up the composition.

                                                                                                                    ShortProcedures Section
                                                                                                                    Comments

                                                                                                                    Procedures Section

                                                                                                                    Control0..1
                                                                                                                    TypeBackboneElement
                                                                                                                    Is Modifierfalse
                                                                                                                    Summaryfalse
                                                                                                                    LabelProcedures Section
                                                                                                                    Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                                    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                                    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    760. Composition.section:procedures_section.id
                                                                                                                    Definition

                                                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                    ShortUnique id for inter-element referencing
                                                                                                                    Control0..1
                                                                                                                    Typestring
                                                                                                                    Is Modifierfalse
                                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                    Summaryfalse
                                                                                                                    762. Composition.section:procedures_section.extension
                                                                                                                    Definition

                                                                                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                    ShortAdditional content defined by implementations
                                                                                                                    Comments

                                                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                    Control0..*
                                                                                                                    TypeExtension
                                                                                                                    Is Modifierfalse
                                                                                                                    Summaryfalse
                                                                                                                    Alternate Namesextensions, user content
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                    764. Composition.section:procedures_section.modifierExtension
                                                                                                                    Definition

                                                                                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                    Comments

                                                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                    Control0..*
                                                                                                                    TypeExtension
                                                                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                    Summarytrue
                                                                                                                    Requirements

                                                                                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                    Alternate Namesextensions, user content, modifiers
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                    766. Composition.section:procedures_section.title
                                                                                                                    Definition

                                                                                                                    The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                                    Shorttitle
                                                                                                                    Comments

                                                                                                                    The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                                    Control1..1
                                                                                                                    Typestring
                                                                                                                    Is Modifierfalse
                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                    Summaryfalse
                                                                                                                    Requirements

                                                                                                                    Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                                    Alternate Namesheader, label, caption
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    768. Composition.section:procedures_section.code
                                                                                                                    Definition

                                                                                                                    A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                                    ShortHistory of Procedures
                                                                                                                    Comments

                                                                                                                    The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                                    If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                                    Control1..1
                                                                                                                    BindingFor example codes, see DocumentSectionCodes
                                                                                                                    (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                                                    Classification of a section of a composition/document.

                                                                                                                    TypeCodeableConcept
                                                                                                                    Is Modifierfalse
                                                                                                                    Summaryfalse
                                                                                                                    Requirements

                                                                                                                    Provides computable standardized labels to topics within the document.

                                                                                                                    LabelHistory of Procedures
                                                                                                                    Pattern Value{
                                                                                                                      "coding" : [{
                                                                                                                        "system" : "http://loinc.org",
                                                                                                                        "code" : "47519-4"
                                                                                                                      }]
                                                                                                                    }
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    770. Composition.section:procedures_section.author
                                                                                                                    Definition

                                                                                                                    Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                                                    ShortWho and/or what authored the section
                                                                                                                    Control0..*
                                                                                                                    TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                                    Is Modifierfalse
                                                                                                                    Summaryfalse
                                                                                                                    Requirements

                                                                                                                    Identifies who is responsible for the content.

                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    772. Composition.section:procedures_section.focus
                                                                                                                    Definition

                                                                                                                    The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                                    ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                                    Comments

                                                                                                                    Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                                                    Control0..1
                                                                                                                    TypeReference(Resource)
                                                                                                                    Is Modifierfalse
                                                                                                                    Summaryfalse
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    774. Composition.section:procedures_section.text
                                                                                                                    Definition

                                                                                                                    A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                                                                    Shorttext
                                                                                                                    Comments

                                                                                                                    Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                                    Control1..1
                                                                                                                    This element is affected by the following invariants: cmp-1
                                                                                                                    TypeNarrative
                                                                                                                    Is Modifierfalse
                                                                                                                    Summaryfalse
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    776. Composition.section:procedures_section.mode
                                                                                                                    Definition

                                                                                                                    How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                                    Shortworking | snapshot | changes
                                                                                                                    Comments

                                                                                                                    This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                                    Control0..1
                                                                                                                    BindingThe codes SHALL be taken from ListMode
                                                                                                                    (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                                    The processing mode that applies to this section.

                                                                                                                    Typecode
                                                                                                                    Is Modifierfalse
                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                    Summaryfalse
                                                                                                                    Requirements

                                                                                                                    Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    778. Composition.section:procedures_section.orderedBy
                                                                                                                    Definition

                                                                                                                    Specifies the order applied to the items in the section entries.

                                                                                                                    ShortOrder of section entries
                                                                                                                    Comments

                                                                                                                    Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                                    Control0..1
                                                                                                                    BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                                    (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                                                    What order applies to the items in the entry.

                                                                                                                    TypeCodeableConcept
                                                                                                                    Is Modifierfalse
                                                                                                                    Summaryfalse
                                                                                                                    Requirements

                                                                                                                    Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    780. Composition.section:procedures_section.entry
                                                                                                                    Definition

                                                                                                                    A reference to the actual resource from which the narrative in the section is derived.

                                                                                                                    Shortentry
                                                                                                                    Comments

                                                                                                                    If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                                    Control0..*
                                                                                                                    This element is affected by the following invariants: cmp-2
                                                                                                                    TypeReference(Resource)
                                                                                                                    Is Modifierfalse
                                                                                                                    Summaryfalse
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                                                                    • profile @ resolve()
                                                                                                                    • 782. Composition.section:procedures_section.entry:sliceEntry
                                                                                                                      Slice NamesliceEntry
                                                                                                                      Definition

                                                                                                                      A reference to the actual resource from which the narrative in the section is derived.

                                                                                                                      ShortA reference to data that supports this section
                                                                                                                      Comments

                                                                                                                      If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                                      Control0..*
                                                                                                                      This element is affected by the following invariants: cmp-2
                                                                                                                      TypeReference(US Core Procedure Profile)
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      784. Composition.section:procedures_section.emptyReason
                                                                                                                      Definition

                                                                                                                      If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                                      ShortWhy the section is empty
                                                                                                                      Comments

                                                                                                                      The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                                      Control0..1
                                                                                                                      This element is affected by the following invariants: cmp-2
                                                                                                                      BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                                                      (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                                                                      If a section is empty, why it is empty.

                                                                                                                      TypeCodeableConcept
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Requirements

                                                                                                                      Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      786. Composition.section:procedures_section.section
                                                                                                                      Definition

                                                                                                                      A nested sub-section within this section.

                                                                                                                      ShortNested Section
                                                                                                                      Comments

                                                                                                                      Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                                      Control0..*
                                                                                                                      This element is affected by the following invariants: cmp-1
                                                                                                                      TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      788. Composition.section:reason_for_visit_section
                                                                                                                      Slice Namereason_for_visit_section
                                                                                                                      Definition

                                                                                                                      The root of the sections that make up the composition.

                                                                                                                      ShortReason for Visit Section
                                                                                                                      Comments

                                                                                                                      Reason for Visit Section

                                                                                                                      Control0..1
                                                                                                                      TypeBackboneElement
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      LabelReason for Visit Section
                                                                                                                      Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                                      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                                      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      790. Composition.section:reason_for_visit_section.id
                                                                                                                      Definition

                                                                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                      ShortUnique id for inter-element referencing
                                                                                                                      Control0..1
                                                                                                                      Typestring
                                                                                                                      Is Modifierfalse
                                                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                      Summaryfalse
                                                                                                                      792. Composition.section:reason_for_visit_section.extension
                                                                                                                      Definition

                                                                                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                      ShortAdditional content defined by implementations
                                                                                                                      Comments

                                                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                      Control0..*
                                                                                                                      TypeExtension
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Alternate Namesextensions, user content
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                      794. Composition.section:reason_for_visit_section.modifierExtension
                                                                                                                      Definition

                                                                                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                                                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                      Comments

                                                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                      Control0..*
                                                                                                                      TypeExtension
                                                                                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                      Summarytrue
                                                                                                                      Requirements

                                                                                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                      Alternate Namesextensions, user content, modifiers
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                      796. Composition.section:reason_for_visit_section.title
                                                                                                                      Definition

                                                                                                                      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                                      Shorttitle
                                                                                                                      Comments

                                                                                                                      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                                      Control1..1
                                                                                                                      Typestring
                                                                                                                      Is Modifierfalse
                                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                      Summaryfalse
                                                                                                                      Requirements

                                                                                                                      Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                                      Alternate Namesheader, label, caption
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      798. Composition.section:reason_for_visit_section.code
                                                                                                                      Definition

                                                                                                                      A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                                      ShortReason for visit
                                                                                                                      Comments

                                                                                                                      The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                                      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                                      Control1..1
                                                                                                                      BindingFor example codes, see DocumentSectionCodes
                                                                                                                      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                                                      Classification of a section of a composition/document.

                                                                                                                      TypeCodeableConcept
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Requirements

                                                                                                                      Provides computable standardized labels to topics within the document.

                                                                                                                      LabelReason for visit
                                                                                                                      Pattern Value{
                                                                                                                        "coding" : [{
                                                                                                                          "system" : "http://loinc.org",
                                                                                                                          "code" : "29299-5"
                                                                                                                        }]
                                                                                                                      }
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      800. Composition.section:reason_for_visit_section.author
                                                                                                                      Definition

                                                                                                                      Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                                                      ShortWho and/or what authored the section
                                                                                                                      Control0..*
                                                                                                                      TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Requirements

                                                                                                                      Identifies who is responsible for the content.

                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      802. Composition.section:reason_for_visit_section.focus
                                                                                                                      Definition

                                                                                                                      The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                                      ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                                      Comments

                                                                                                                      Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                                                      Control0..1
                                                                                                                      TypeReference(Resource)
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      804. Composition.section:reason_for_visit_section.text
                                                                                                                      Definition

                                                                                                                      A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                                                                      ShortThis section contains only human readable content
                                                                                                                      Comments

                                                                                                                      Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                                      Control1..1
                                                                                                                      This element is affected by the following invariants: cmp-1
                                                                                                                      TypeNarrative
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      806. Composition.section:reason_for_visit_section.mode
                                                                                                                      Definition

                                                                                                                      How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                                      Shortworking | snapshot | changes
                                                                                                                      Comments

                                                                                                                      This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                                      Control0..1
                                                                                                                      BindingThe codes SHALL be taken from ListMode
                                                                                                                      (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                                      The processing mode that applies to this section.

                                                                                                                      Typecode
                                                                                                                      Is Modifierfalse
                                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                      Summaryfalse
                                                                                                                      Requirements

                                                                                                                      Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      808. Composition.section:reason_for_visit_section.orderedBy
                                                                                                                      Definition

                                                                                                                      Specifies the order applied to the items in the section entries.

                                                                                                                      ShortOrder of section entries
                                                                                                                      Comments

                                                                                                                      Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                                      Control0..1
                                                                                                                      BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                                      (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                                                      What order applies to the items in the entry.

                                                                                                                      TypeCodeableConcept
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Requirements

                                                                                                                      Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      810. Composition.section:reason_for_visit_section.entry
                                                                                                                      Definition

                                                                                                                      A reference to the actual resource from which the narrative in the section is derived.

                                                                                                                      ShortA reference to data that supports this section
                                                                                                                      Comments

                                                                                                                      If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                                      Control0..*
                                                                                                                      This element is affected by the following invariants: cmp-2
                                                                                                                      TypeReference(Resource)
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      812. Composition.section:reason_for_visit_section.emptyReason
                                                                                                                      Definition

                                                                                                                      If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                                      ShortWhy the section is empty
                                                                                                                      Comments

                                                                                                                      The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                                      Control0..1
                                                                                                                      This element is affected by the following invariants: cmp-2
                                                                                                                      BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                                                      (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                                                                      If a section is empty, why it is empty.

                                                                                                                      TypeCodeableConcept
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Requirements

                                                                                                                      Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      814. Composition.section:reason_for_visit_section.section
                                                                                                                      Definition

                                                                                                                      A nested sub-section within this section.

                                                                                                                      ShortNested Section
                                                                                                                      Comments

                                                                                                                      Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                                      Control0..*
                                                                                                                      This element is affected by the following invariants: cmp-1
                                                                                                                      TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      816. Composition.section:review_of_systems_section
                                                                                                                      Slice Namereview_of_systems_section
                                                                                                                      Definition

                                                                                                                      The root of the sections that make up the composition.

                                                                                                                      ShortReview of Systems Section
                                                                                                                      Comments

                                                                                                                      Review of Systems Section

                                                                                                                      Control0..1
                                                                                                                      TypeBackboneElement
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      LabelReview of Systems Section
                                                                                                                      Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                                      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                                      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      818. Composition.section:review_of_systems_section.id
                                                                                                                      Definition

                                                                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                      ShortUnique id for inter-element referencing
                                                                                                                      Control0..1
                                                                                                                      Typestring
                                                                                                                      Is Modifierfalse
                                                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                      Summaryfalse
                                                                                                                      820. Composition.section:review_of_systems_section.extension
                                                                                                                      Definition

                                                                                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                      ShortAdditional content defined by implementations
                                                                                                                      Comments

                                                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                      Control0..*
                                                                                                                      TypeExtension
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Alternate Namesextensions, user content
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                      822. Composition.section:review_of_systems_section.modifierExtension
                                                                                                                      Definition

                                                                                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                                                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                      Comments

                                                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                      Control0..*
                                                                                                                      TypeExtension
                                                                                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                      Summarytrue
                                                                                                                      Requirements

                                                                                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                      Alternate Namesextensions, user content, modifiers
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                      824. Composition.section:review_of_systems_section.title
                                                                                                                      Definition

                                                                                                                      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                                      Shorttitle
                                                                                                                      Comments

                                                                                                                      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                                      Control1..1
                                                                                                                      Typestring
                                                                                                                      Is Modifierfalse
                                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                      Summaryfalse
                                                                                                                      Requirements

                                                                                                                      Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                                      Alternate Namesheader, label, caption
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      826. Composition.section:review_of_systems_section.code
                                                                                                                      Definition

                                                                                                                      A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                                      ShortReview of systems
                                                                                                                      Comments

                                                                                                                      The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                                      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                                      Control1..1
                                                                                                                      BindingFor example codes, see DocumentSectionCodes
                                                                                                                      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                                                      Classification of a section of a composition/document.

                                                                                                                      TypeCodeableConcept
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Requirements

                                                                                                                      Provides computable standardized labels to topics within the document.

                                                                                                                      LabelReview of systems
                                                                                                                      Pattern Value{
                                                                                                                        "coding" : [{
                                                                                                                          "system" : "http://loinc.org",
                                                                                                                          "code" : "10187-3"
                                                                                                                        }]
                                                                                                                      }
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      828. Composition.section:review_of_systems_section.author
                                                                                                                      Definition

                                                                                                                      Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                                                      ShortWho and/or what authored the section
                                                                                                                      Control0..*
                                                                                                                      TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Requirements

                                                                                                                      Identifies who is responsible for the content.

                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      830. Composition.section:review_of_systems_section.focus
                                                                                                                      Definition

                                                                                                                      The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                                      ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                                      Comments

                                                                                                                      Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                                                      Control0..1
                                                                                                                      TypeReference(Resource)
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      832. Composition.section:review_of_systems_section.text
                                                                                                                      Definition

                                                                                                                      A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                                                                      ShortThis section contains only human readable content
                                                                                                                      Comments

                                                                                                                      Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                                      Control1..1
                                                                                                                      This element is affected by the following invariants: cmp-1
                                                                                                                      TypeNarrative
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      834. Composition.section:review_of_systems_section.mode
                                                                                                                      Definition

                                                                                                                      How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                                      Shortworking | snapshot | changes
                                                                                                                      Comments

                                                                                                                      This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                                      Control0..1
                                                                                                                      BindingThe codes SHALL be taken from ListMode
                                                                                                                      (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                                      The processing mode that applies to this section.

                                                                                                                      Typecode
                                                                                                                      Is Modifierfalse
                                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                      Summaryfalse
                                                                                                                      Requirements

                                                                                                                      Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      836. Composition.section:review_of_systems_section.orderedBy
                                                                                                                      Definition

                                                                                                                      Specifies the order applied to the items in the section entries.

                                                                                                                      ShortOrder of section entries
                                                                                                                      Comments

                                                                                                                      Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                                      Control0..1
                                                                                                                      BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                                      (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                                                      What order applies to the items in the entry.

                                                                                                                      TypeCodeableConcept
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Requirements

                                                                                                                      Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      838. Composition.section:review_of_systems_section.entry
                                                                                                                      Definition

                                                                                                                      A reference to the actual resource from which the narrative in the section is derived.

                                                                                                                      ShortA reference to data that supports this section
                                                                                                                      Comments

                                                                                                                      If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                                      Control0..*
                                                                                                                      This element is affected by the following invariants: cmp-2
                                                                                                                      TypeReference(Resource)
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      840. Composition.section:review_of_systems_section.emptyReason
                                                                                                                      Definition

                                                                                                                      If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                                      ShortWhy the section is empty
                                                                                                                      Comments

                                                                                                                      The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                                      Control0..1
                                                                                                                      This element is affected by the following invariants: cmp-2
                                                                                                                      BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                                                      (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                                                                      If a section is empty, why it is empty.

                                                                                                                      TypeCodeableConcept
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Requirements

                                                                                                                      Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      842. Composition.section:review_of_systems_section.section
                                                                                                                      Definition

                                                                                                                      A nested sub-section within this section.

                                                                                                                      ShortNested Section
                                                                                                                      Comments

                                                                                                                      Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                                      Control0..*
                                                                                                                      This element is affected by the following invariants: cmp-1
                                                                                                                      TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      844. Composition.section:social_history_section
                                                                                                                      Slice Namesocial_history_section
                                                                                                                      Definition

                                                                                                                      The root of the sections that make up the composition.

                                                                                                                      ShortSocial History Section
                                                                                                                      Comments

                                                                                                                      Social History Section

                                                                                                                      Control0..1
                                                                                                                      TypeBackboneElement
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      LabelSocial History Section
                                                                                                                      Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                                      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                                      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      846. Composition.section:social_history_section.id
                                                                                                                      Definition

                                                                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                      ShortUnique id for inter-element referencing
                                                                                                                      Control0..1
                                                                                                                      Typestring
                                                                                                                      Is Modifierfalse
                                                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                      Summaryfalse
                                                                                                                      848. Composition.section:social_history_section.extension
                                                                                                                      Definition

                                                                                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                      ShortAdditional content defined by implementations
                                                                                                                      Comments

                                                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                      Control0..*
                                                                                                                      TypeExtension
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Alternate Namesextensions, user content
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                      850. Composition.section:social_history_section.modifierExtension
                                                                                                                      Definition

                                                                                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                                                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                      Comments

                                                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                      Control0..*
                                                                                                                      TypeExtension
                                                                                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                      Summarytrue
                                                                                                                      Requirements

                                                                                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                      Alternate Namesextensions, user content, modifiers
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                      852. Composition.section:social_history_section.title
                                                                                                                      Definition

                                                                                                                      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                                      Shorttitle
                                                                                                                      Comments

                                                                                                                      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                                      Control1..1
                                                                                                                      Typestring
                                                                                                                      Is Modifierfalse
                                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                      Summaryfalse
                                                                                                                      Requirements

                                                                                                                      Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                                      Alternate Namesheader, label, caption
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      854. Composition.section:social_history_section.code
                                                                                                                      Definition

                                                                                                                      A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                                      ShortSocial history
                                                                                                                      Comments

                                                                                                                      The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                                      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                                      Control1..1
                                                                                                                      BindingFor example codes, see DocumentSectionCodes
                                                                                                                      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                                                      Classification of a section of a composition/document.

                                                                                                                      TypeCodeableConcept
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Requirements

                                                                                                                      Provides computable standardized labels to topics within the document.

                                                                                                                      LabelSocial history
                                                                                                                      Pattern Value{
                                                                                                                        "coding" : [{
                                                                                                                          "system" : "http://loinc.org",
                                                                                                                          "code" : "29762-2"
                                                                                                                        }]
                                                                                                                      }
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      856. Composition.section:social_history_section.author
                                                                                                                      Definition

                                                                                                                      Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                                                      ShortWho and/or what authored the section
                                                                                                                      Control0..*
                                                                                                                      TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Requirements

                                                                                                                      Identifies who is responsible for the content.

                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      858. Composition.section:social_history_section.focus
                                                                                                                      Definition

                                                                                                                      The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                                      ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                                      Comments

                                                                                                                      Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                                                      Control0..1
                                                                                                                      TypeReference(Resource)
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      860. Composition.section:social_history_section.text
                                                                                                                      Definition

                                                                                                                      A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                                                                      Shorttext
                                                                                                                      Comments

                                                                                                                      Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                                      Control1..1
                                                                                                                      This element is affected by the following invariants: cmp-1
                                                                                                                      TypeNarrative
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      862. Composition.section:social_history_section.mode
                                                                                                                      Definition

                                                                                                                      How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                                      Shortworking | snapshot | changes
                                                                                                                      Comments

                                                                                                                      This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                                      Control0..1
                                                                                                                      BindingThe codes SHALL be taken from ListMode
                                                                                                                      (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                                      The processing mode that applies to this section.

                                                                                                                      Typecode
                                                                                                                      Is Modifierfalse
                                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                      Summaryfalse
                                                                                                                      Requirements

                                                                                                                      Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      864. Composition.section:social_history_section.orderedBy
                                                                                                                      Definition

                                                                                                                      Specifies the order applied to the items in the section entries.

                                                                                                                      ShortOrder of section entries
                                                                                                                      Comments

                                                                                                                      Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                                      Control0..1
                                                                                                                      BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                                      (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                                                      What order applies to the items in the entry.

                                                                                                                      TypeCodeableConcept
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Requirements

                                                                                                                      Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      866. Composition.section:social_history_section.entry
                                                                                                                      Definition

                                                                                                                      A reference to the actual resource from which the narrative in the section is derived.

                                                                                                                      Shortentry
                                                                                                                      Comments

                                                                                                                      If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                                      Control0..*
                                                                                                                      This element is affected by the following invariants: cmp-2
                                                                                                                      TypeReference(Resource)
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                                                                      • profile @ resolve()
                                                                                                                      • 868. Composition.section:social_history_section.entry:sliceEntry
                                                                                                                        Slice NamesliceEntry
                                                                                                                        Definition

                                                                                                                        A reference to the actual resource from which the narrative in the section is derived.

                                                                                                                        ShortSmoking status
                                                                                                                        Comments

                                                                                                                        If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                                        Control0..*
                                                                                                                        This element is affected by the following invariants: cmp-2
                                                                                                                        TypeReference(US Core Smoking Status Observation Profile)
                                                                                                                        Is Modifierfalse
                                                                                                                        Summaryfalse
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        870. Composition.section:social_history_section.emptyReason
                                                                                                                        Definition

                                                                                                                        If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                                        ShortWhy the section is empty
                                                                                                                        Comments

                                                                                                                        The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                                        Control0..1
                                                                                                                        This element is affected by the following invariants: cmp-2
                                                                                                                        BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                                                        (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                                                                        If a section is empty, why it is empty.

                                                                                                                        TypeCodeableConcept
                                                                                                                        Is Modifierfalse
                                                                                                                        Summaryfalse
                                                                                                                        Requirements

                                                                                                                        Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        872. Composition.section:social_history_section.section
                                                                                                                        Definition

                                                                                                                        A nested sub-section within this section.

                                                                                                                        ShortNested Section
                                                                                                                        Comments

                                                                                                                        Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                                        Control0..*
                                                                                                                        This element is affected by the following invariants: cmp-1
                                                                                                                        TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                                        Is Modifierfalse
                                                                                                                        Summaryfalse
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        874. Composition.section:vital_signs_section
                                                                                                                        Slice Namevital_signs_section
                                                                                                                        Definition

                                                                                                                        The root of the sections that make up the composition.

                                                                                                                        ShortVital Signs Section
                                                                                                                        Comments

                                                                                                                        Vital Signs Section

                                                                                                                        Control0..1
                                                                                                                        TypeBackboneElement
                                                                                                                        Is Modifierfalse
                                                                                                                        Summaryfalse
                                                                                                                        LabelVital Signs Section
                                                                                                                        Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                                        cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                                        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        876. Composition.section:vital_signs_section.id
                                                                                                                        Definition

                                                                                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                        ShortUnique id for inter-element referencing
                                                                                                                        Control0..1
                                                                                                                        Typestring
                                                                                                                        Is Modifierfalse
                                                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                        Summaryfalse
                                                                                                                        878. Composition.section:vital_signs_section.extension
                                                                                                                        Definition

                                                                                                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                        ShortAdditional content defined by implementations
                                                                                                                        Comments

                                                                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                        Control0..*
                                                                                                                        TypeExtension
                                                                                                                        Is Modifierfalse
                                                                                                                        Summaryfalse
                                                                                                                        Alternate Namesextensions, user content
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                        880. Composition.section:vital_signs_section.modifierExtension
                                                                                                                        Definition

                                                                                                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can 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.

                                                                                                                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                        Comments

                                                                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                        Control0..*
                                                                                                                        TypeExtension
                                                                                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                        Summarytrue
                                                                                                                        Requirements

                                                                                                                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                        Alternate Namesextensions, user content, modifiers
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                        882. Composition.section:vital_signs_section.title
                                                                                                                        Definition

                                                                                                                        The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                                        Shorttitle
                                                                                                                        Comments

                                                                                                                        The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                                        Control1..1
                                                                                                                        Typestring
                                                                                                                        Is Modifierfalse
                                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                        Summaryfalse
                                                                                                                        Requirements

                                                                                                                        Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                                        Alternate Namesheader, label, caption
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        884. Composition.section:vital_signs_section.code
                                                                                                                        Definition

                                                                                                                        A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                                        ShortVital signs
                                                                                                                        Comments

                                                                                                                        The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                                        If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                                        Control1..1
                                                                                                                        BindingFor example codes, see DocumentSectionCodes
                                                                                                                        (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                                                        Classification of a section of a composition/document.

                                                                                                                        TypeCodeableConcept
                                                                                                                        Is Modifierfalse
                                                                                                                        Summaryfalse
                                                                                                                        Requirements

                                                                                                                        Provides computable standardized labels to topics within the document.

                                                                                                                        LabelVital signs
                                                                                                                        Pattern Value{
                                                                                                                          "coding" : [{
                                                                                                                            "system" : "http://loinc.org",
                                                                                                                            "code" : "8716-3"
                                                                                                                          }]
                                                                                                                        }
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        886. Composition.section:vital_signs_section.author
                                                                                                                        Definition

                                                                                                                        Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                                                        ShortWho and/or what authored the section
                                                                                                                        Control0..*
                                                                                                                        TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                                        Is Modifierfalse
                                                                                                                        Summaryfalse
                                                                                                                        Requirements

                                                                                                                        Identifies who is responsible for the content.

                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        888. Composition.section:vital_signs_section.focus
                                                                                                                        Definition

                                                                                                                        The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                                        ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                                        Comments

                                                                                                                        Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                                                        Control0..1
                                                                                                                        TypeReference(Resource)
                                                                                                                        Is Modifierfalse
                                                                                                                        Summaryfalse
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        890. Composition.section:vital_signs_section.text
                                                                                                                        Definition

                                                                                                                        A human-readable narrative that contains the attested content of the section, 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 "clinically safe" for a human to just read the narrative.

                                                                                                                        Shorttext
                                                                                                                        Comments

                                                                                                                        Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                                        Control1..1
                                                                                                                        This element is affected by the following invariants: cmp-1
                                                                                                                        TypeNarrative
                                                                                                                        Is Modifierfalse
                                                                                                                        Summaryfalse
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        892. Composition.section:vital_signs_section.mode
                                                                                                                        Definition

                                                                                                                        How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                                        Shortworking | snapshot | changes
                                                                                                                        Comments

                                                                                                                        This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                                        Control0..1
                                                                                                                        BindingThe codes SHALL be taken from ListMode
                                                                                                                        (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                                        The processing mode that applies to this section.

                                                                                                                        Typecode
                                                                                                                        Is Modifierfalse
                                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                        Summaryfalse
                                                                                                                        Requirements

                                                                                                                        Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        894. Composition.section:vital_signs_section.orderedBy
                                                                                                                        Definition

                                                                                                                        Specifies the order applied to the items in the section entries.

                                                                                                                        ShortOrder of section entries
                                                                                                                        Comments

                                                                                                                        Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                                        Control0..1
                                                                                                                        BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                                        (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                                                        What order applies to the items in the entry.

                                                                                                                        TypeCodeableConcept
                                                                                                                        Is Modifierfalse
                                                                                                                        Summaryfalse
                                                                                                                        Requirements

                                                                                                                        Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        896. Composition.section:vital_signs_section.entry
                                                                                                                        Definition

                                                                                                                        A reference to the actual resource from which the narrative in the section is derived.

                                                                                                                        Shortentry
                                                                                                                        Comments

                                                                                                                        If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                                        Control0..*
                                                                                                                        This element is affected by the following invariants: cmp-2
                                                                                                                        TypeReference(Resource)
                                                                                                                        Is Modifierfalse
                                                                                                                        Summaryfalse
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                                                                                        • profile @ resolve()
                                                                                                                        • 898. Composition.section:vital_signs_section.entry:sliceEntry
                                                                                                                          Slice NamesliceEntry
                                                                                                                          Definition

                                                                                                                          A reference to the actual resource from which the narrative in the section is derived.

                                                                                                                          ShortA reference to data that supports this section
                                                                                                                          Comments

                                                                                                                          If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                                                          Control0..*
                                                                                                                          This element is affected by the following invariants: cmp-2
                                                                                                                          TypeReference(Vital Signs Profile)
                                                                                                                          Is Modifierfalse
                                                                                                                          Summaryfalse
                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          900. Composition.section:vital_signs_section.emptyReason
                                                                                                                          Definition

                                                                                                                          If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                                          ShortWhy the section is empty
                                                                                                                          Comments

                                                                                                                          The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                                          Control0..1
                                                                                                                          This element is affected by the following invariants: cmp-2
                                                                                                                          BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                                                          (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                                                                          If a section is empty, why it is empty.

                                                                                                                          TypeCodeableConcept
                                                                                                                          Is Modifierfalse
                                                                                                                          Summaryfalse
                                                                                                                          Requirements

                                                                                                                          Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          902. Composition.section:vital_signs_section.section
                                                                                                                          Definition

                                                                                                                          A nested sub-section within this section.

                                                                                                                          ShortNested Section
                                                                                                                          Comments

                                                                                                                          Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                                          Control0..*
                                                                                                                          This element is affected by the following invariants: cmp-1
                                                                                                                          TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                                          Is Modifierfalse
                                                                                                                          Summaryfalse
                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))