Quality Measure Implementation Guide (STU4)
4.0.0 - STU4 United States of America flag

This page is part of the Quality Measure STU2 for FHIR R4 Implementation Guide (v4.0.0: STU4 (v4.0.0)) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Resource Profile: CQFMQualityProgram - XML Profile

Active as of 2021-11-27

XML representation of the quality-program-cqfm resource profile.

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<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="quality-program-cqfm"/>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml">Placeholder</div>
  </text>
  <url
       value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/quality-program-cqfm"/>
  <version value="4.0.0"/>
  <name value="CQFMQualityProgram"/>
  <title value="CQFM Quality Program"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2021-11-27T13:31:32-07:00"/>
  <publisher value="Clinical Quality Information WG"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/cqi"/>
    </telecom>
  </contact>
  <description
               value="Defines and supports the definition of Quality Programs"/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
    </coding>
  </jurisdiction>
  <purpose
           value="Quality programs must be able to specify the set of measures they use, as well as provide versioning information for all the dependencies used in a particular release to enable stable expansion of value sets. Specifically, the versions of code systems used to construct value sets referenced by the measures must be identified so that terminology servers performing expansions can unambiguously select the version of each code system used to perform the expansion."/>
  <fhirVersion value="4.0.1"/>
  <mapping>
    <identity value="rim"/>
    <uri value="http://hl7.org/v3"/>
    <name value="RIM Mapping"/>
  </mapping>
  <mapping>
    <identity value="workflow"/>
    <uri value="http://hl7.org/fhir/workflow"/>
    <name value="Workflow Pattern"/>
  </mapping>
  <mapping>
    <identity value="w5"/>
    <uri value="http://hl7.org/fhir/fivews"/>
    <name value="FiveWs Pattern Mapping"/>
  </mapping>
  <mapping>
    <identity value="objimpl"/>
    <uri value="http://hl7.org/fhir/object-implementation"/>
    <name value="Object Implementation Information"/>
  </mapping>
  <kind value="resource"/>
  <abstract value="false"/>
  <type value="Library"/>
  <baseDefinition
                  value="http://hl7.org/fhir/StructureDefinition/shareablelibrary"/>
  <derivation value="constraint"/>
  <snapshot>
    <element id="Library">
      <path value="Library"/>
      <short value="Represents a library of quality improvement components"/>
      <definition
                  value="Represents an overall quality program as well as the measures and version-specific dependencies of those measures that are included in a release specification of a quality program. This profile is used prior to release (when the status is draft) of the quality program to establish the expansion rules such as code system versions used for expansion of value sets while measures are being authored, as well as to specify a full release of a quality program, optionally specifying expansion identifiers for value sets to ensure stability of value set expansions used for evaluation of the measures."/>
      <comment
               value="Prior to release, a quality program should specify code system versions to support stable expansion of value sets during the development phase of the artifacts involved in the quality program (also called an expansion profile). Post release, a quality program may specify expansion identifiers to lock the code lists used for value sets. Provisional codes can be specified using the code system version mechanism (i.e. it is not the case that only one code system version can be specified per code system in an expand, and a manifest)."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Library"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <constraint>
        <key value="dom-2"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/>
        <expression value="contained.contained.empty()"/>
        <xpath value="not(parent::f:contained and f:contained)"/>
        <source
                value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-3"/>
        <severity value="error"/>
        <human
               value="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"/>
        <expression
                    value="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()"/>
        <xpath
               value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))"/>
        <source
                value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-4"/>
        <severity value="error"/>
        <human
               value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/>
        <expression
                    value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/>
        <xpath
               value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/>
        <source
                value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-5"/>
        <severity value="error"/>
        <human
               value="If a resource is contained in another resource, it SHALL NOT have a security label"/>
        <expression value="contained.meta.security.empty()"/>
        <xpath value="not(exists(f:contained/*/f:meta/f:security))"/>
        <source
                value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
          <valueBoolean value="true"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
          <valueMarkdown
                         value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."/>
        </extension>
        <key value="dom-6"/>
        <severity value="warning"/>
        <human
               value="A resource should have narrative for robust management"/>
        <expression value="text.`div`.exists()"/>
        <xpath value="exists(f:text/h:div)"/>
        <source
                value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <key value="lib-0"/>
        <severity value="warning"/>
        <human
               value="Name should be usable as an identifier for the module by machine processing applications such as code generation"/>
        <expression value="name.matches('[A-Z]([A-Za-z0-9_]){0,254}')"/>
        <xpath
               value="not(exists(f:name/@value)) or matches(f:name/@value, '[A-Z]([A-Za-z0-9_]){0,254}')"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Library"/>
      </constraint>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="Entity. Role, or Act"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Act[classCode=GROUPER;moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="Library.id">
      <path value="Library.id"/>
      <short value="Logical id of this artifact"/>
      <definition
                  value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/>
      <comment
               value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="id"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Library.meta">
      <path value="Library.meta"/>
      <short value="Metadata about the resource"/>
      <definition
                  value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.meta"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Meta"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Library.implicitRules">
      <path value="Library.implicitRules"/>
      <short value="A set of rules under which this content was created"/>
      <definition
                  value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc."/>
      <comment
               value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. 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."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.implicitRules"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="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"/>
      <isSummary value="true"/>
    </element>
    <element id="Library.language">
      <path value="Library.language"/>
      <short value="Language of the resource content"/>
      <definition
                  value="The base language in which the resource is written."/>
      <comment
               value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.language"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/>
        </extension>
        <strength value="preferred"/>
        <description value="A human language."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/languages"/>
      </binding>
    </element>
    <element id="Library.text">
      <path value="Library.text"/>
      <short value="Text summary of the resource, for human interpretation"/>
      <definition
                  value="A human-readable narrative that contains a summary of the resource and 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 &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety."/>
      <comment
               value="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 &quot;text blob&quot; or where text is additionally entered raw or narrated and encoded information is added later."/>
      <alias value="narrative"/>
      <alias value="html"/>
      <alias value="xhtml"/>
      <alias value="display"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Narrative"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="Act.text?"/>
      </mapping>
    </element>
    <element id="Library.contained">
      <path value="Library.contained"/>
      <short value="Contained, inline Resources"/>
      <definition
                  value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope."/>
      <comment
               value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels."/>
      <alias value="inline resources"/>
      <alias value="anonymous resources"/>
      <alias value="contained resources"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.contained"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Resource"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Library.extension">
      <path value="Library.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Library.extension:partOf">
      <path value="Library.extension"/>
      <sliceName value="partOf"/>
      <short value="What program this is part of"/>
      <definition
                  value="Specifies an overall quality program that this manifest or release is part of."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-partOf"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
    </element>
    <element id="Library.extension:directReferenceCode">
      <path value="Library.extension"/>
      <sliceName value="directReferenceCode"/>
      <short value="A code directly referenced by the measure"/>
      <definition
                  value="Defines a code directly referenced by measure logic, as opposed to a value set. Direct reference codes may be the target of data requirements."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
    </element>
    <element id="Library.extension:cqlOptions">
      <path value="Library.extension"/>
      <sliceName value="cqlOptions"/>
      <short value="What options"/>
      <definition
                  value="Specifies a parameters (contained) resource that identifies the options for the CQL-to-ELM translator associated with the CQL content."/>
      <comment
               value="When this extension is used with a specific CQL library, it indicates the options that are to be used to translate the CQL to ELM. ELM Libraries carry the options they were translated with, so this does not need to be specified. If the options are not specified, the translation options identified [here](using-cql.html#translation-to-elm) are used."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-cqlOptions"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
    </element>
    <element id="Library.extension:expansionParameters">
      <path value="Library.extension"/>
      <sliceName value="expansionParameters"/>
      <short value="What expansion rules"/>
      <definition
                  value="Specifies the expansion parameters that should be used to expand the ValueSet, or any ValueSets in the Library (or referenced by components of the Library)."/>
      <comment
               value="For a complete description of how these expansion rules impact the behavior of the expansion operation, see the [Expansion Rules](measure-terminology-service.html#expansion-rules) topic."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-expansionParameters"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
    </element>
    <element id="Library.modifierExtension">
      <path value="Library.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it 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)."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <requirements
                    value="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](http://hl7.org/fhir/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Library.url">
      <path value="Library.url"/>
      <short
             value="Canonical identifier for this library, represented as a URI (globally unique)"/>
      <definition
                  value="An absolute URI that is used to identify this library when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative instance of this library is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the library is stored on different servers."/>
      <comment
               value="Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred.  Multiple instances may share the same URL if they have a distinct version.

The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author.  Considerations for making this decision are found in [Technical and Business Versions](http://hl7.org/fhir/resource.html#versions). 

In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the [meta.source](http://hl7.org/fhir/resource.html#meta) element to indicate where the current master source of the resource can be found."/>
      <requirements
                    value="Allows the library to be referenced by a single globally unique identifier."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Library.url"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Definition.url"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.identifier"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".identifier[scope=BUSN;reliability=ISS]"/>
      </mapping>
    </element>
    <element id="Library.identifier">
      <path value="Library.identifier"/>
      <short value="Additional identifier for the library"/>
      <definition
                  value="A formal identifier that is used to identify this library when it is represented in other formats, or referenced in a specification, model, design or an instance. e.g. CMS or NQF identifiers for a measure artifact. Note that at least one identifier is required for non-experimental active artifacts."/>
      <comment
               value="Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this library outside of FHIR, where it is not possible to use the logical URI."/>
      <requirements
                    value="Allows externally provided and/or usable business identifiers to be easily associated with the module."/>
      <min value="1"/>
      <max value="*"/>
      <base>
        <path value="Library.identifier"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Definition.identifier"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.identifier"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".identifier"/>
      </mapping>
      <mapping>
        <identity value="objimpl"/>
        <map value="no-gen-base"/>
      </mapping>
    </element>
    <element id="Library.version">
      <path value="Library.version"/>
      <short value="Business version of the library"/>
      <definition
                  value="The identifier that is used to identify this version of the library when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the library author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence. To provide a version consistent with the Decision Support Service specification, use the format Major.Minor.Revision (e.g. 1.0.0). For more information on versioning knowledge assets, refer to the Decision Support Service specification. Note that a version is required for non-experimental active artifacts."/>
      <comment
               value="There may be different library instances that have the same identifier but different versions.  The version can be appended to the url in a reference to allow a reference to a particular business version of the library with the format [url]|[version]."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Library.version"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Definition.version"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.version"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="N/A (to add?)"/>
      </mapping>
    </element>
    <element id="Library.name">
      <path value="Library.name"/>
      <short value="Name for this library (computer friendly)"/>
      <definition
                  value="A natural language name identifying the library. This name should be usable as an identifier for the module by machine processing applications such as code generation."/>
      <comment
               value="The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly."/>
      <requirements value="Support human navigation and code generation."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Library.name"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <condition value="inv-0"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Library.title">
      <path value="Library.title"/>
      <short value="Name for this library (human friendly)"/>
      <definition
                  value="A short, descriptive, user-friendly title for the library."/>
      <comment
               value="This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Library.title"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Definition.title"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".title"/>
      </mapping>
    </element>
    <element id="Library.subtitle">
      <path value="Library.subtitle"/>
      <short value="Subordinate title of the library"/>
      <definition
                  value="An explanatory or alternate title for the library giving additional information about its content."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Library.subtitle"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Library.status">
      <path value="Library.status"/>
      <short value="draft | active | retired | unknown"/>
      <definition
                  value="The status of this library. Enables tracking the life-cycle of the content."/>
      <comment
               value="Allows filtering of libraries that are appropriate for use vs. not."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Library.status"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="This is labeled as &quot;Is Modifier&quot; because applications should not use a retired {{title}} without due consideration"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="PublicationStatus"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/>
        </extension>
        <strength value="required"/>
        <description value="The lifecycle status of an artifact."/>
        <valueSet
                  value="http://hl7.org/fhir/ValueSet/publication-status|4.0.1"/>
      </binding>
      <mapping>
        <identity value="workflow"/>
        <map value="Definition.status"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.status"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".status"/>
      </mapping>
    </element>
    <element id="Library.experimental">
      <path value="Library.experimental"/>
      <short value="For testing purposes, not real usage"/>
      <definition
                  value="A Boolean value to indicate that this library is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage."/>
      <comment
               value="Allows filtering of librarys that are appropriate for use versus not."/>
      <requirements
                    value="Enables experimental content to be developed following the same lifecycle that would be used for a production-level library."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Library.experimental"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Definition.experimental"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.class"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="N/A (to add?)"/>
      </mapping>
    </element>
    <element id="Library.type">
      <path value="Library.type"/>
      <short
             value="logic-library | model-definition | asset-collection | module-definition"/>
      <definition
                  value="Identifies the type of library such as a Logic Library, Model Definition, Asset Collection, or Module Definition."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Library.type"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <patternCodeableConcept>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/library-type"/>
          <code value="asset-collection"/>
        </coding>
      </patternCodeableConcept>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="LibraryType"/>
        </extension>
        <strength value="extensible"/>
        <description
                     value="The type of knowledge asset this library contains."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/library-type"/>
      </binding>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.what[x]"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".code"/>
      </mapping>
    </element>
    <element id="Library.subject[x]">
      <path value="Library.subject[x]"/>
      <short value="Type of individual the library content is focused on"/>
      <definition
                  value="A code or group definition that describes the intended subject of the contents of the library."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Library.subject[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group"/>
      </type>
      <meaningWhenMissing value="Patient"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="SubjectType"/>
        </extension>
        <strength value="extensible"/>
        <description
                     value="The possible types of subjects for a library (E.g. Patient, Practitioner, Organization, Location, etc.)."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/subject-type"/>
      </binding>
    </element>
    <element id="Library.date">
      <path value="Library.date"/>
      <short value="Date last changed"/>
      <definition
                  value="The date  (and optionally time) when the library was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the library changes."/>
      <comment
               value="Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the library. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource."/>
      <alias value="Revision Date"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Library.date"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Definition.date"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.recorded"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=AUT].time"/>
      </mapping>
    </element>
    <element id="Library.publisher">
      <path value="Library.publisher"/>
      <short value="Name of the publisher (organization or individual)"/>
      <definition
                  value="The name of the organization or individual that published the library."/>
      <comment
               value="Usually an organization but may be an individual. The publisher (or steward) of the library is the organization or individual primarily responsible for the maintenance and upkeep of the library. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the library. This item SHOULD be populated unless the information is available from context."/>
      <requirements
                    value="Helps establish the &quot;authority/credibility&quot; of the library.  May also allow for contact."/>
      <alias value="steward"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Library.publisher"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Definition.publisher"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.witness"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=AUT].role"/>
      </mapping>
    </element>
    <element id="Library.contact">
      <path value="Library.contact"/>
      <short value="Contact details for the publisher"/>
      <definition
                  value="Contact details to assist a user in finding and communicating with the publisher."/>
      <comment
               value="May be a web site, an email address, a telephone number, etc."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Library.contact"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="ContactDetail"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Definition.contact"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=CALLBCK].role"/>
      </mapping>
    </element>
    <element id="Library.description">
      <path value="Library.description"/>
      <short value="Natural language description of the library"/>
      <definition
                  value="A free text natural language description of the library from a consumer's perspective."/>
      <comment
               value="This description can be used to capture details such as why the library was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the library as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the library is presumed to be the predominant language in the place the library was created)."/>
      <alias value="scope"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Library.description"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="markdown"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Definition.description"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".text"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Library.useContext">
      <path value="Library.useContext"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="code"/>
        </discriminator>
        <rules value="open"/>
      </slicing>
      <short value="The context that the content is intended to support"/>
      <definition
                  value="The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate library instances."/>
      <comment
               value="When multiple useContexts are specified, there is no expectation that all or any of the contexts apply."/>
      <requirements value="Assist in searching for appropriate content."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Library.useContext"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="UsageContext"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Definition.useContext"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="N/A (to add?)"/>
      </mapping>
    </element>
    <element id="Library.useContext:qualityProgram">
      <path value="Library.useContext"/>
      <sliceName value="qualityProgram"/>
      <short value="The context that the content is intended to support"/>
      <definition value="Supporting the definition of Quality Pograms."/>
      <comment
               value="When multiple useContexts are specified, there is no expectation that all or any of the contexts apply."/>
      <requirements value="Assist in searching for appropriate content."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Library.useContext"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="UsageContext"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Definition.useContext"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="N/A (to add?)"/>
      </mapping>
    </element>
    <element id="Library.useContext:qualityProgram.id">
      <path value="Library.useContext.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Library.useContext:qualityProgram.extension">
      <path value="Library.useContext.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. 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."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Library.useContext:qualityProgram.code">
      <path value="Library.useContext.code"/>
      <short value="Type of context being specified"/>
      <definition
                  value="A code that identifies the type of context being specified by this usage context."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="UsageContext.code"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Coding"/>
      </type>
      <patternCoding>
        <system
                value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
        <code value="program"/>
      </patternCoding>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="UsageContextType"/>
        </extension>
        <strength value="extensible"/>
        <description
                     value="A code that specifies a type of context being specified by a usage context."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/usage-context-type"/>
      </binding>
    </element>
    <element id="Library.useContext:qualityProgram.value[x]">
      <path value="Library.useContext.value[x]"/>
      <short value="Value that defines the context"/>
      <definition
                  value="Support the defintion of Quality Programs and that the set of identified quality program is not exhaustive and not prescribing codes for programs."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="UsageContext.value[x]"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <strength value="example"/>
        <description
                     value="Supports the defintion of Quality Programs and that the set of identified quality program is not exhaustive and not prescribing codes for programs"/>
        <valueSet
                  value="http://hl7.org/fhir/us/cqfmeasures/ValueSet/quality-programs"/>
      </binding>
    </element>
    <element id="Library.jurisdiction">
      <path value="Library.jurisdiction"/>
      <short value="Intended jurisdiction for library (if applicable)"/>
      <definition
                  value="A legal or geographic region in which the library is intended to be used."/>
      <comment
               value="It may be possible for the library to be used in jurisdictions other than those for which it was originally designed or intended."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Library.jurisdiction"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Jurisdiction"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/>
        </extension>
        <strength value="extensible"/>
        <description
                     value="Countries and regions within which this artifact is targeted for use."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/jurisdiction"/>
      </binding>
      <mapping>
        <identity value="workflow"/>
        <map value="Definition.jurisdiction"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="N/A (to add?)"/>
      </mapping>
    </element>
    <element id="Library.purpose">
      <path value="Library.purpose"/>
      <short value="Why this library is defined"/>
      <definition
                  value="Explanation of why this library is needed and why it has been designed as it has."/>
      <comment
               value="This element does not describe the usage of the library. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is.  This may be used to point to source materials or specifications that drove the structure of this library."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Library.purpose"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="markdown"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Definition.purpose"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.why[x]"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".reasonCode.text"/>
      </mapping>
      <mapping>
        <identity value="objimpl"/>
        <map value="no-gen-base"/>
      </mapping>
    </element>
    <element id="Library.usage">
      <path value="Library.usage"/>
      <short value="Describes the clinical usage of the library"/>
      <definition
                  value="A detailed description of how the library is used from a clinical perspective."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Library.usage"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A (to add?)"/>
      </mapping>
    </element>
    <element id="Library.copyright">
      <path value="Library.copyright"/>
      <short value="Use and/or publishing restrictions"/>
      <definition
                  value="A copyright statement relating to the library and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the library."/>
      <requirements
                    value="Consumers must be able to determine any legal restrictions on the use of the library and/or its content."/>
      <alias value="License"/>
      <alias value="Restrictions"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Library.copyright"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="markdown"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Definition.copyright"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="N/A (to add?)"/>
      </mapping>
      <mapping>
        <identity value="objimpl"/>
        <map value="no-gen-base"/>
      </mapping>
    </element>
    <element id="Library.approvalDate">
      <path value="Library.approvalDate"/>
      <short value="When the library was approved by publisher"/>
      <definition
                  value="The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage."/>
      <comment
               value="The 'date' element may be more recent than the approval date because of minor changes or editorial corrections."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Library.approvalDate"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="date"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Definition.approvalDate"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=&quot;SUBJ&quot;].act[classCode=CACT;moodCode=EVN;code=&quot;approval&quot;].effectiveTime"/>
      </mapping>
      <mapping>
        <identity value="objimpl"/>
        <map value="no-gen-base"/>
      </mapping>
    </element>
    <element id="Library.lastReviewDate">
      <path value="Library.lastReviewDate"/>
      <short value="When the library was last reviewed"/>
      <definition
                  value="The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date."/>
      <comment
               value="If specified, this date follows the original approval date."/>
      <requirements
                    value="Gives a sense of how &quot;current&quot; the content is.  Resources that have not been reviewed in a long time may have a risk of being less appropriate/relevant."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Library.lastReviewDate"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="date"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Definition.lastReviewDate"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=&quot;SUBJ&quot;; subsetCode=&quot;RECENT&quot;].act[classCode=CACT;moodCode=EVN;code=&quot;review&quot;].effectiveTime"/>
      </mapping>
      <mapping>
        <identity value="objimpl"/>
        <map value="no-gen-base"/>
      </mapping>
    </element>
    <element id="Library.effectivePeriod">
      <path value="Library.effectivePeriod"/>
      <short value="When the library is expected to be used"/>
      <definition
                  value="The period during which the library content was or is planned to be in active use."/>
      <comment
               value="The effective period for a library  determines when the content is applicable for usage and is independent of publication and review dates. For example, a measure intended to be used for the year 2016 might be published in 2015."/>
      <requirements
                    value="Allows establishing a transition before a resource comes into effect and also allows for a sunsetting  process when new versions of the library are or are expected to be used instead."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Library.effectivePeriod"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Period"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Definition.effectivePeriod"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="N/A (to add?)"/>
      </mapping>
      <mapping>
        <identity value="objimpl"/>
        <map value="no-gen-base"/>
      </mapping>
    </element>
    <element id="Library.topic">
      <path value="Library.topic"/>
      <short value="E.g. Education, Treatment, Assessment, etc."/>
      <definition
                  value="Descriptive topics related to the content of the library. Topics provide a high-level categorization of the library that can be useful for filtering and searching."/>
      <requirements
                    value="Repositories must be able to determine how to categorize the library so that it can be found by topical searches."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Library.topic"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DefinitionTopic"/>
        </extension>
        <strength value="example"/>
        <description
                     value="High-level categorization of the definition, used for searching, sorting, and filtering."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/definition-topic"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="N/A (to add?)"/>
      </mapping>
    </element>
    <element id="Library.author">
      <path value="Library.author"/>
      <short value="Who authored the content"/>
      <definition
                  value="An individiual or organization primarily involved in the creation and maintenance of the content."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Library.author"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="ContactDetail"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=AUT]"/>
      </mapping>
    </element>
    <element id="Library.editor">
      <path value="Library.editor"/>
      <short value="Who edited the content"/>
      <definition
                  value="An individual or organization primarily responsible for internal coherence of the content."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Library.editor"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="ContactDetail"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Library.reviewer">
      <path value="Library.reviewer"/>
      <short value="Who reviewed the content"/>
      <definition
                  value="An individual or organization primarily responsible for review of some aspect of the content."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Library.reviewer"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="ContactDetail"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map
             value=".participation[typeCode=VRF] {not clear whether VRF best corresponds to reviewer or endorser}"/>
      </mapping>
    </element>
    <element id="Library.endorser">
      <path value="Library.endorser"/>
      <short value="Who endorsed the content"/>
      <definition
                  value="An individual or organization responsible for officially endorsing the content for use in some setting."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Library.endorser"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="ContactDetail"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map
             value=".participation[typeCode=VRF] {not clear whether VRF best corresponds to reviewer or endorser}"/>
      </mapping>
    </element>
    <element id="Library.relatedArtifact">
      <path value="Library.relatedArtifact"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="type"/>
        </discriminator>
        <rules value="open"/>
      </slicing>
      <short value="Additional documentation, citations, etc."/>
      <definition
                  value="Related artifacts such as additional documentation, justification, or bibliographic references."/>
      <comment
               value="Each related artifact is either an attachment, or a reference to another resource, but not both."/>
      <requirements
                    value="Libraries must be able to provide enough information for consumers of the content (and/or interventions or results produced by the content) to be able to determine and understand the justification for and evidence in support of the content."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Library.relatedArtifact"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="RelatedArtifact"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=DOC,RSON,PREV, DRIV, USE, COMP] {successor would be PREV w/ inversionInd=true; No support for citation}"/>
      </mapping>
    </element>
    <element id="Library.relatedArtifact:measure">
      <path value="Library.relatedArtifact"/>
      <sliceName value="measure"/>
      <short value="Measure (and version)"/>
      <definition value="A measure included in the quality program release."/>
      <comment
               value="Each related artifact is either an attachment, or a reference to another resource, but not both."/>
      <requirements
                    value="The version of the measure used SHALL be specified in the canonical URL of the measure."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Library.relatedArtifact"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="RelatedArtifact"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=DOC,RSON,PREV, DRIV, USE, COMP] {successor would be PREV w/ inversionInd=true; No support for citation}"/>
      </mapping>
    </element>
    <element id="Library.relatedArtifact:measure.id">
      <path value="Library.relatedArtifact.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Library.relatedArtifact:measure.extension">
      <path value="Library.relatedArtifact.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. 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."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="Library.relatedArtifact:measure.extension:programIdentifier">
      <path value="Library.relatedArtifact.extension"/>
      <sliceName value="programIdentifier"/>
      <short value="Measure number within the program"/>
      <definition
                  value="Provides an identifier for the measure within the program."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-programIdentifier"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Library.relatedArtifact:measure.extension:qualityDomain">
      <path value="Library.relatedArtifact.extension"/>
      <sliceName value="qualityDomain"/>
      <short value="What domain"/>
      <definition
                  value="Specifies the quality domain within the program that the measure covers or is related to."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-qualityDomain"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element
             id="Library.relatedArtifact:measure.extension:meaningfulMeasureArea">
      <path value="Library.relatedArtifact.extension"/>
      <sliceName value="meaningfulMeasureArea"/>
      <short value="What measure area"/>
      <definition
                  value="Specifies the Meaningful Measures Area within the program that the measure covers or is related to."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-meaningfulMeasureArea"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Library.relatedArtifact:measure.type">
      <path value="Library.relatedArtifact.type"/>
      <short
             value="documentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of"/>
      <definition value="The type of relationship to the related artifact."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="RelatedArtifact.type"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <fixedCode value="composed-of"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="RelatedArtifactType"/>
        </extension>
        <strength value="required"/>
        <description
                     value="The type of relationship to the related artifact."/>
        <valueSet
                  value="http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1"/>
      </binding>
    </element>
    <element id="Library.relatedArtifact:measure.label">
      <path value="Library.relatedArtifact.label"/>
      <short value="Short label"/>
      <definition
                  value="A short label that can be used to reference the citation from elsewhere in the containing artifact, such as a footnote index."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="RelatedArtifact.label"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Library.relatedArtifact:measure.display">
      <path value="Library.relatedArtifact.display"/>
      <short value="Brief description of the related artifact"/>
      <definition
                  value="A brief description of the document or knowledge resource being referenced, suitable for display to a consumer."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="RelatedArtifact.display"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Library.relatedArtifact:measure.citation">
      <path value="Library.relatedArtifact.citation"/>
      <short value="Bibliographic citation for the artifact"/>
      <definition
                  value="A bibliographic citation for the related artifact. This text SHOULD be formatted according to an accepted citation format."/>
      <comment
               value="Additional structured information about citations should be captured as extensions."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="RelatedArtifact.citation"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="markdown"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Library.relatedArtifact:measure.url">
      <path value="Library.relatedArtifact.url"/>
      <short value="Where the artifact can be accessed"/>
      <definition
                  value="A url for the artifact that can be followed to access the actual content."/>
      <comment
               value="If a document or resource element is present, this element SHALL NOT be provided (use the url or reference in the Attachment or resource reference)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="RelatedArtifact.url"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="url"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Library.relatedArtifact:measure.document">
      <path value="Library.relatedArtifact.document"/>
      <short value="What document is being referenced"/>
      <definition
                  value="The document being referenced, represented as an attachment. This is exclusive with the resource element."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="RelatedArtifact.document"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Attachment"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Library.relatedArtifact:measure.resource">
      <path value="Library.relatedArtifact.resource"/>
      <short value="What resource is being referenced"/>
      <definition
                  value="The related resource, such as a library, value set, profile, or other knowledge resource."/>
      <comment
               value="If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="RelatedArtifact.resource"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="canonical"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Measure"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Library"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/ValueSet"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Library.relatedArtifact:dependency">
      <path value="Library.relatedArtifact"/>
      <sliceName value="dependency"/>
      <short value="Library, CodeSystem, or ValueSet (and version)"/>
      <definition
                  value="A Library, CodeSystem, or ValueSet referenced by any quality measure in the release, or any dependency of any quality measure in the release."/>
      <comment
               value="This is the full list of dependencies of all measures used in the quality program."/>
      <requirements
                    value="Quality programs must be able to unambiguously specify the versions of all dependencies used by measures in the quality program. The version of each dependency SHALL be included in the canonical reference to the dependency."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Library.relatedArtifact"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="RelatedArtifact"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=DOC,RSON,PREV, DRIV, USE, COMP] {successor would be PREV w/ inversionInd=true; No support for citation}"/>
      </mapping>
    </element>
    <element id="Library.relatedArtifact:dependency.id">
      <path value="Library.relatedArtifact.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Library.relatedArtifact:dependency.extension">
      <path value="Library.relatedArtifact.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. 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."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Library.relatedArtifact:dependency.type">
      <path value="Library.relatedArtifact.type"/>
      <short
             value="documentation | justification | citation | predecessor | successor | derived-from | depends-on | composed-of"/>
      <definition value="The type of relationship to the related artifact."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="RelatedArtifact.type"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <fixedCode value="depends-on"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="RelatedArtifactType"/>
        </extension>
        <strength value="required"/>
        <description
                     value="The type of relationship to the related artifact."/>
        <valueSet
                  value="http://hl7.org/fhir/ValueSet/related-artifact-type|4.0.1"/>
      </binding>
    </element>
    <element id="Library.relatedArtifact:dependency.label">
      <path value="Library.relatedArtifact.label"/>
      <short value="Short label"/>
      <definition
                  value="A short label that can be used to reference the citation from elsewhere in the containing artifact, such as a footnote index."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="RelatedArtifact.label"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Library.relatedArtifact:dependency.display">
      <path value="Library.relatedArtifact.display"/>
      <short value="Brief description of the related artifact"/>
      <definition
                  value="A brief description of the document or knowledge resource being referenced, suitable for display to a consumer."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="RelatedArtifact.display"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Library.relatedArtifact:dependency.citation">
      <path value="Library.relatedArtifact.citation"/>
      <short value="Bibliographic citation for the artifact"/>
      <definition
                  value="A bibliographic citation for the related artifact. This text SHOULD be formatted according to an accepted citation format."/>
      <comment
               value="Additional structured information about citations should be captured as extensions."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="RelatedArtifact.citation"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="markdown"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Library.relatedArtifact:dependency.url">
      <path value="Library.relatedArtifact.url"/>
      <short value="Where the artifact can be accessed"/>
      <definition
                  value="A url for the artifact that can be followed to access the actual content."/>
      <comment
               value="If a document or resource element is present, this element SHALL NOT be provided (use the url or reference in the Attachment or resource reference)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="RelatedArtifact.url"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="url"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Library.relatedArtifact:dependency.document">
      <path value="Library.relatedArtifact.document"/>
      <short value="What document is being referenced"/>
      <definition
                  value="The document being referenced, represented as an attachment. This is exclusive with the resource element."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="RelatedArtifact.document"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Attachment"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Library.relatedArtifact:dependency.resource">
      <path value="Library.relatedArtifact.resource"/>
      <short value="What resource is being referenced"/>
      <definition
                  value="The related resource, such as a library, value set, profile, or other knowledge resource."/>
      <comment
               value="If the type is predecessor, this is a reference to the succeeding knowledge resource. If the type is successor, this is a reference to the prior knowledge resource."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="RelatedArtifact.resource"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="canonical"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/CodeSystem"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Library"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/ValueSet"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Library.parameter">
      <path value="Library.parameter"/>
      <short value="Parameters defined by the library"/>
      <definition
                  value="The parameter element defines parameters used by the library."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Library.parameter"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="ParameterDefinition"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A (to add?)"/>
      </mapping>
    </element>
    <element id="Library.dataRequirement">
      <path value="Library.dataRequirement"/>
      <short value="What data is referenced by this library"/>
      <definition
                  value="Describes a set of data that must be provided in order to be able to successfully perform the computations defined by the library."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Library.dataRequirement"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="DataRequirement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A (to add?)"/>
      </mapping>
    </element>
    <element id="Library.content">
      <path value="Library.content"/>
      <short value="Contents of the library, either embedded or referenced"/>
      <definition
                  value="Contents of the library, either embedded or referenced."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Library.content"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Attachment"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".text"/>
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="Library">
      <path value="Library"/>
      <definition
                  value="Represents an overall quality program as well as the measures and version-specific dependencies of those measures that are included in a release specification of a quality program. This profile is used prior to release (when the status is draft) of the quality program to establish the expansion rules such as code system versions used for expansion of value sets while measures are being authored, as well as to specify a full release of a quality program, optionally specifying expansion identifiers for value sets to ensure stability of value set expansions used for evaluation of the measures."/>
      <comment
               value="Prior to release, a quality program should specify code system versions to support stable expansion of value sets during the development phase of the artifacts involved in the quality program (also called an expansion profile). Post release, a quality program may specify expansion identifiers to lock the code lists used for value sets. Provisional codes can be specified using the code system version mechanism (i.e. it is not the case that only one code system version can be specified per code system in an expand, and a manifest)."/>
      <mustSupport value="false"/>
    </element>
    <element id="Library.text">
      <path value="Library.text"/>
      <min value="1"/>
      <max value="1"/>
      <mustSupport value="true"/>
    </element>
    <element id="Library.extension:partOf">
      <path value="Library.extension"/>
      <sliceName value="partOf"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-partOf"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element id="Library.extension:directReferenceCode">
      <path value="Library.extension"/>
      <sliceName value="directReferenceCode"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element id="Library.extension:cqlOptions">
      <path value="Library.extension"/>
      <sliceName value="cqlOptions"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-cqlOptions"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element id="Library.extension:expansionParameters">
      <path value="Library.extension"/>
      <sliceName value="expansionParameters"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-expansionParameters"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element id="Library.identifier">
      <path value="Library.identifier"/>
      <min value="1"/>
      <max value="*"/>
      <mustSupport value="true"/>
    </element>
    <element id="Library.title">
      <path value="Library.title"/>
      <min value="1"/>
      <max value="1"/>
      <mustSupport value="true"/>
    </element>
    <element id="Library.type">
      <path value="Library.type"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <patternCodeableConcept>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/library-type"/>
          <code value="asset-collection"/>
        </coding>
      </patternCodeableConcept>
      <mustSupport value="true"/>
    </element>
    <element id="Library.date">
      <path value="Library.date"/>
      <min value="1"/>
      <max value="1"/>
      <mustSupport value="true"/>
    </element>
    <element id="Library.useContext">
      <path value="Library.useContext"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="code"/>
        </discriminator>
        <rules value="open"/>
      </slicing>
      <mustSupport value="true"/>
    </element>
    <element id="Library.useContext:qualityProgram">
      <path value="Library.useContext"/>
      <sliceName value="qualityProgram"/>
      <definition value="Supporting the definition of Quality Pograms."/>
      <min value="0"/>
      <max value="1"/>
      <mustSupport value="true"/>
    </element>
    <element id="Library.useContext:qualityProgram.code">
      <path value="Library.useContext.code"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Coding"/>
      </type>
      <patternCoding>
        <system
                value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
        <code value="program"/>
      </patternCoding>
      <mustSupport value="true"/>
    </element>
    <element id="Library.useContext:qualityProgram.value[x]">
      <path value="Library.useContext.value[x]"/>
      <definition
                  value="Support the defintion of Quality Programs and that the set of identified quality program is not exhaustive and not prescribing codes for programs."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mustSupport value="true"/>
      <binding>
        <strength value="example"/>
        <description
                     value="Supports the defintion of Quality Programs and that the set of identified quality program is not exhaustive and not prescribing codes for programs"/>
        <valueSet
                  value="http://hl7.org/fhir/us/cqfmeasures/ValueSet/quality-programs"/>
      </binding>
    </element>
    <element id="Library.effectivePeriod">
      <path value="Library.effectivePeriod"/>
      <mustSupport value="true"/>
    </element>
    <element id="Library.relatedArtifact">
      <path value="Library.relatedArtifact"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="type"/>
        </discriminator>
        <rules value="open"/>
      </slicing>
      <mustSupport value="true"/>
    </element>
    <element id="Library.relatedArtifact:measure">
      <path value="Library.relatedArtifact"/>
      <sliceName value="measure"/>
      <short value="Measure (and version)"/>
      <definition value="A measure included in the quality program release."/>
      <requirements
                    value="The version of the measure used SHALL be specified in the canonical URL of the measure."/>
      <min value="0"/>
      <max value="*"/>
      <mustSupport value="true"/>
    </element>
    <element
             id="Library.relatedArtifact:measure.extension:programIdentifier">
      <path value="Library.relatedArtifact.extension"/>
      <sliceName value="programIdentifier"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-programIdentifier"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element id="Library.relatedArtifact:measure.extension:qualityDomain">
      <path value="Library.relatedArtifact.extension"/>
      <sliceName value="qualityDomain"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-qualityDomain"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element
             id="Library.relatedArtifact:measure.extension:meaningfulMeasureArea">
      <path value="Library.relatedArtifact.extension"/>
      <sliceName value="meaningfulMeasureArea"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-meaningfulMeasureArea"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element id="Library.relatedArtifact:measure.type">
      <path value="Library.relatedArtifact.type"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <fixedCode value="composed-of"/>
      <mustSupport value="true"/>
    </element>
    <element id="Library.relatedArtifact:measure.display">
      <path value="Library.relatedArtifact.display"/>
      <min value="0"/>
      <max value="1"/>
      <mustSupport value="true"/>
    </element>
    <element id="Library.relatedArtifact:measure.resource">
      <path value="Library.relatedArtifact.resource"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="canonical"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Measure"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Library"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/ValueSet"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element id="Library.relatedArtifact:dependency">
      <path value="Library.relatedArtifact"/>
      <sliceName value="dependency"/>
      <short value="Library, CodeSystem, or ValueSet (and version)"/>
      <definition
                  value="A Library, CodeSystem, or ValueSet referenced by any quality measure in the release, or any dependency of any quality measure in the release."/>
      <comment
               value="This is the full list of dependencies of all measures used in the quality program."/>
      <requirements
                    value="Quality programs must be able to unambiguously specify the versions of all dependencies used by measures in the quality program. The version of each dependency SHALL be included in the canonical reference to the dependency."/>
      <min value="0"/>
      <max value="*"/>
      <mustSupport value="true"/>
    </element>
    <element id="Library.relatedArtifact:dependency.type">
      <path value="Library.relatedArtifact.type"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <fixedCode value="depends-on"/>
      <mustSupport value="true"/>
    </element>
    <element id="Library.relatedArtifact:dependency.display">
      <path value="Library.relatedArtifact.display"/>
      <min value="0"/>
      <max value="1"/>
      <mustSupport value="true"/>
    </element>
    <element id="Library.relatedArtifact:dependency.resource">
      <path value="Library.relatedArtifact.resource"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="canonical"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/CodeSystem"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Library"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/ValueSet"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element id="Library.content">
      <path value="Library.content"/>
      <definition
                  value="Contents of the library, either embedded or referenced."/>
      <min value="0"/>
      <max value="0"/>
      <type>
        <code value="Attachment"/>
      </type>
      <mustSupport value="false"/>
    </element>
  </differential>
</StructureDefinition>