HL7 FHIR Profile: Occupational Data for Health (ODH), Release 1 (Standard for Trial Use)

This page is part of the Occupational Data for Health (ODH) FHIR IG (v0.1.0: STU 1 Ballot 1) based on FHIR R3. The current version which supercedes this version is 1.2.0. For a full list of available versions, see the Directory of published versions

ClinicalNoteModel


<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="cimi-statement-ClinicalNote-model"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
  <p><b>ODH ClinicalNote Logical Model</b></p>
  <p>An entry concerning a patient where the result is a narrative text.</p>
</div>
  </text>
  <url
       value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-statement-ClinicalNote-model"/>
  <identifier>
    <system value="http://hl7.org/fhir/us/odh"/>
    <value value="cimi.statement.ClinicalNote"/>
  </identifier>
  <version value="0.1.0"/>
  <name value="ClinicalNoteModel"/>
  <title value="ODH ClinicalNote Logical Model"/>
  <status value="draft"/>
  <date value="2018-08-17T00:00:00+10:00"/>
  <publisher value="HL7"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://standardhealthrecord.org"/>
    </telecom>
  </contact>
  <description
               value="An entry concerning a patient where the result is a narrative text."/>
  <keyword>
    <system value="http://ncimeta.nci.nih.gov"/>
    <code value="C0747978"/>
    <display value="Progress Note"/>
  </keyword>
  <kind value="logical"/>
  <abstract value="false"/>
  <type value="cimi-statement-ClinicalNote-model"/>
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Element"/>
  <derivation value="specialization"/>
  <snapshot>
    <element id="cimi-statement-ClinicalNote-model">
      <path value="cimi-statement-ClinicalNote-model"/>
      <definition
                  value="An entry concerning a patient where the result is a narrative text."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="cimi-statement-ClinicalNote-model"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="cimi-statement-ClinicalNote-model.personOfRecord">
      <path value="cimi-statement-ClinicalNote-model.personOfRecord"/>
      <code>
        <system value="http://ncimeta.nci.nih.gov"/>
        <code value="C0027361"/>
      </code>
      <short value="The person this entry belongs to."/>
      <definition value="The person this entry belongs to."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="cimi-statement-ClinicalNote-model.personOfRecord"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-entity-Person-model"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="cimi-statement-ClinicalNote-model.recorded">
      <path value="cimi-statement-ClinicalNote-model.recorded"/>
      <short
             value="The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order."/>
      <definition
                  value="The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="cimi-statement-ClinicalNote-model.recorded"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code
              value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-core-Attribution-model"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="cimi-statement-ClinicalNote-model.signed">
      <path value="cimi-statement-ClinicalNote-model.signed"/>
      <short
             value="Provenance information specific to the signing of the clinical statement."/>
      <definition
                  value="Provenance information specific to the signing of the clinical statement."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="cimi-statement-ClinicalNote-model.signed"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code
              value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-core-Attribution-model"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="cimi-statement-ClinicalNote-model.additionalText">
      <path value="cimi-statement-ClinicalNote-model.additionalText"/>
      <code>
        <system value="http://ncimeta.nci.nih.gov"/>
        <code value="C0947611"/>
      </code>
      <short
             value="A text note containing additional details, explanation, description, comment, or summarization. Details can discuss, support, explain changes to, or dispute information."/>
      <definition
                  value="A text note containing additional details, explanation, description, comment, or summarization. Details can discuss, support, explain changes to, or dispute information."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="cimi-statement-ClinicalNote-model.additionalText"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="cimi-statement-ClinicalNote-model.contextCode">
      <path value="cimi-statement-ClinicalNote-model.contextCode"/>
      <short
             value="Code representing the sense in which the statement is interpreted, for example, the degree of presence in a PresenceStatement."/>
      <definition
                  value="Code representing the sense in which the statement is interpreted, for example, the degree of presence in a PresenceStatement."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="cimi-statement-ClinicalNote-model.contextCode"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Coding"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="cimi-statement-ClinicalNote-model.contextCode.id">
      <path value="cimi-statement-ClinicalNote-model.contextCode.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <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>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="cimi-statement-ClinicalNote-model.contextCode.extension">
      <path value="cimi-statement-ClinicalNote-model.contextCode.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. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <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."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="cimi-statement-ClinicalNote-model.contextCode.system">
      <path value="cimi-statement-ClinicalNote-model.contextCode.system"/>
      <short value="Identity of the terminology system"/>
      <definition
                  value="The identification of the code system that defines the meaning of the symbol in the code."/>
      <comment
               value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7&#39;s list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously."/>
      <requirements
                    value="Need to be unambiguous about the source of the definition of the symbol."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Coding.system"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <fixedUri value="http://snomed.info/sct"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./codeSystem"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/>
      </mapping>
    </element>
    <element id="cimi-statement-ClinicalNote-model.contextCode.version">
      <path value="cimi-statement-ClinicalNote-model.contextCode.version"/>
      <short value="Version of the system - if relevant"/>
      <definition
                  value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged."/>
      <comment
               value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Coding.version"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./codeSystemVersion"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/>
      </mapping>
    </element>
    <element id="cimi-statement-ClinicalNote-model.contextCode.code">
      <path value="cimi-statement-ClinicalNote-model.contextCode.code"/>
      <short value="Symbol in syntax defined by the system"/>
      <definition
                  value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)."/>
      <requirements value="Need to refer to a particular code in the system."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Coding.code"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <fixedCode value="424975005"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.1"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./code"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/>
      </mapping>
    </element>
    <element id="cimi-statement-ClinicalNote-model.contextCode.display">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/>
      </extension>
      <path value="cimi-statement-ClinicalNote-model.contextCode.display"/>
      <short value="Representation defined by the system"/>
      <definition
                  value="A representation of the meaning of the code in the system, following the rules of the system."/>
      <requirements
                    value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Coding.display"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.2 - but note this is not well followed"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="CV.displayName"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/>
      </mapping>
    </element>
    <element id="cimi-statement-ClinicalNote-model.contextCode.userSelected">
      <path value="cimi-statement-ClinicalNote-model.contextCode.userSelected"/>
      <short value="If this coding was chosen directly by the user"/>
      <definition
                  value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)."/>
      <comment
               value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly &#39;directly chosen&#39; implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely."/>
      <requirements
                    value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Coding.userSelected"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="Sometimes implied by being first"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="CD.codingRationale"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source &quot;true&quot;;     fhir:target dt:CDCoding.codingRationale\#O   ]"/>
      </mapping>
    </element>
    <element id="cimi-statement-ClinicalNote-model.statementTopic">
      <path value="cimi-statement-ClinicalNote-model.statementTopic"/>
      <short
             value="Compositional and reusable grouping of clinical statement attributes that make up the clinical focus of a statement."/>
      <definition
                  value="Compositional and reusable grouping of clinical statement attributes that make up the clinical focus of a statement.

StatementTopic class attributes are aligned with SNOMED CT Concept Model attributes when such an overlap exists. Note that this class does not include contextual attributes such as the nature of the action (ordered, proposed, planned, etc...), the nature of the patient state being described (e.g., present, suspected present, absent), and the attribution of this information (the who, when, where, how, why of the information recorded)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="cimi-statement-ClinicalNote-model.statementTopic"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code
              value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-topic-StatementTopic-model"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="cimi-statement-ClinicalNote-model.encounter">
      <path value="cimi-statement-ClinicalNote-model.encounter"/>
      <short
             value="A description of an interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient."/>
      <definition
                  value="A description of an interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="cimi-statement-ClinicalNote-model.encounter"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code
              value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-encounter-Encounter-model"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="cimi-statement-ClinicalNote-model.interpretation">
      <path value="cimi-statement-ClinicalNote-model.interpretation"/>
      <code>
        <system value="http://ncimeta.nci.nih.gov"/>
        <code value="C0420833"/>
      </code>
      <short
             value="A clinical interpretation of a finding (applies to both assertions and observation)."/>
      <definition
                  value="A clinical interpretation of a finding (applies to both assertions and observation)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="cimi-statement-ClinicalNote-model.interpretation"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Coding"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="extensible"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/ValueSet/observation-interpretation"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="cimi-statement-ClinicalNote-model.relevantTime">
      <path value="cimi-statement-ClinicalNote-model.relevantTime"/>
      <short value="The time or time period that the finding addresses."/>
      <definition
                  value="The time or time period that the finding addresses.
The clinically relevant time is not necessarily when the information is gathered or when a test is carried out, but for example, when a specimen was collected, or the time period referred to by the question. Use a TimePeriod for a measurement or specimen collection continued over a significant period of time (e.g. 24 hour Urine Sodium)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="cimi-statement-ClinicalNote-model.relevantTime"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <type>
        <code
              value="http://hl7.org/fhir/us/odh/StructureDefinition/shr-core-TimePeriod-model"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="cimi-statement-ClinicalNote-model.findingMethod">
      <path value="cimi-statement-ClinicalNote-model.findingMethod"/>
      <short
             value="The technique used to create the finding, for example, the specific imaging technical, lab test code, or assessment vehicle."/>
      <definition
                  value="The technique used to create the finding, for example, the specific imaging technical, lab test code, or assessment vehicle."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="cimi-statement-ClinicalNote-model.findingMethod"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Coding"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="preferred"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/us/odh/ValueSet/cimi-statement-FindingMethodVS"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="cimi-statement-ClinicalNote-model.media">
      <path value="cimi-statement-ClinicalNote-model.media"/>
      <short
             value="A file that contains audio, video, image, or similar content."/>
      <definition
                  value="A file that contains audio, video, image, or similar content."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="cimi-statement-ClinicalNote-model.media"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code
              value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-datatypes-Media-model"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
  </snapshot>
  <differential>
    <element id="cimi-statement-ClinicalNote-model">
      <path value="cimi-statement-ClinicalNote-model"/>
      <definition
                  value="An entry concerning a patient where the result is a narrative text."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="cimi-statement-ClinicalNote-model"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="cimi-statement-ClinicalNote-model.personOfRecord">
      <path value="cimi-statement-ClinicalNote-model.personOfRecord"/>
      <code>
        <system value="http://ncimeta.nci.nih.gov"/>
        <code value="C0027361"/>
      </code>
      <short value="The person this entry belongs to."/>
      <definition value="The person this entry belongs to."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="cimi-statement-ClinicalNote-model.personOfRecord"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-entity-Person-model"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="cimi-statement-ClinicalNote-model.recorded">
      <path value="cimi-statement-ClinicalNote-model.recorded"/>
      <short
             value="The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order."/>
      <definition
                  value="The person who entered the order on behalf of another individual for example in the case of a verbal or a telephone order."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="cimi-statement-ClinicalNote-model.recorded"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code
              value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-core-Attribution-model"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="cimi-statement-ClinicalNote-model.signed">
      <path value="cimi-statement-ClinicalNote-model.signed"/>
      <short
             value="Provenance information specific to the signing of the clinical statement."/>
      <definition
                  value="Provenance information specific to the signing of the clinical statement."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="cimi-statement-ClinicalNote-model.signed"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code
              value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-core-Attribution-model"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="cimi-statement-ClinicalNote-model.additionalText">
      <path value="cimi-statement-ClinicalNote-model.additionalText"/>
      <code>
        <system value="http://ncimeta.nci.nih.gov"/>
        <code value="C0947611"/>
      </code>
      <short
             value="A text note containing additional details, explanation, description, comment, or summarization. Details can discuss, support, explain changes to, or dispute information."/>
      <definition
                  value="A text note containing additional details, explanation, description, comment, or summarization. Details can discuss, support, explain changes to, or dispute information."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="cimi-statement-ClinicalNote-model.additionalText"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="cimi-statement-ClinicalNote-model.contextCode">
      <path value="cimi-statement-ClinicalNote-model.contextCode"/>
      <short
             value="Code representing the sense in which the statement is interpreted, for example, the degree of presence in a PresenceStatement."/>
      <definition
                  value="Code representing the sense in which the statement is interpreted, for example, the degree of presence in a PresenceStatement."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="cimi-statement-ClinicalNote-model.contextCode"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Coding"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="cimi-statement-ClinicalNote-model.contextCode.id">
      <path value="cimi-statement-ClinicalNote-model.contextCode.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <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>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="cimi-statement-ClinicalNote-model.contextCode.extension">
      <path value="cimi-statement-ClinicalNote-model.contextCode.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. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <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."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="cimi-statement-ClinicalNote-model.contextCode.system">
      <path value="cimi-statement-ClinicalNote-model.contextCode.system"/>
      <short value="Identity of the terminology system"/>
      <definition
                  value="The identification of the code system that defines the meaning of the symbol in the code."/>
      <comment
               value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7&#39;s list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously."/>
      <requirements
                    value="Need to be unambiguous about the source of the definition of the symbol."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Coding.system"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <fixedUri value="http://snomed.info/sct"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./codeSystem"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/>
      </mapping>
    </element>
    <element id="cimi-statement-ClinicalNote-model.contextCode.version">
      <path value="cimi-statement-ClinicalNote-model.contextCode.version"/>
      <short value="Version of the system - if relevant"/>
      <definition
                  value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged."/>
      <comment
               value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Coding.version"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./codeSystemVersion"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/>
      </mapping>
    </element>
    <element id="cimi-statement-ClinicalNote-model.contextCode.code">
      <path value="cimi-statement-ClinicalNote-model.contextCode.code"/>
      <short value="Symbol in syntax defined by the system"/>
      <definition
                  value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)."/>
      <requirements value="Need to refer to a particular code in the system."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Coding.code"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <fixedCode value="424975005"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.1"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./code"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/>
      </mapping>
    </element>
    <element id="cimi-statement-ClinicalNote-model.contextCode.display">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/>
      </extension>
      <path value="cimi-statement-ClinicalNote-model.contextCode.display"/>
      <short value="Representation defined by the system"/>
      <definition
                  value="A representation of the meaning of the code in the system, following the rules of the system."/>
      <requirements
                    value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Coding.display"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.2 - but note this is not well followed"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="CV.displayName"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/>
      </mapping>
    </element>
    <element id="cimi-statement-ClinicalNote-model.contextCode.userSelected">
      <path value="cimi-statement-ClinicalNote-model.contextCode.userSelected"/>
      <short value="If this coding was chosen directly by the user"/>
      <definition
                  value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)."/>
      <comment
               value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly &#39;directly chosen&#39; implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely."/>
      <requirements
                    value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Coding.userSelected"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="Sometimes implied by being first"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="CD.codingRationale"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source &quot;true&quot;;     fhir:target dt:CDCoding.codingRationale\#O   ]"/>
      </mapping>
    </element>
    <element id="cimi-statement-ClinicalNote-model.statementTopic">
      <path value="cimi-statement-ClinicalNote-model.statementTopic"/>
      <short
             value="Compositional and reusable grouping of clinical statement attributes that make up the clinical focus of a statement."/>
      <definition
                  value="Compositional and reusable grouping of clinical statement attributes that make up the clinical focus of a statement.

StatementTopic class attributes are aligned with SNOMED CT Concept Model attributes when such an overlap exists. Note that this class does not include contextual attributes such as the nature of the action (ordered, proposed, planned, etc...), the nature of the patient state being described (e.g., present, suspected present, absent), and the attribution of this information (the who, when, where, how, why of the information recorded)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="cimi-statement-ClinicalNote-model.statementTopic"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code
              value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-topic-StatementTopic-model"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="cimi-statement-ClinicalNote-model.encounter">
      <path value="cimi-statement-ClinicalNote-model.encounter"/>
      <short
             value="A description of an interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient."/>
      <definition
                  value="A description of an interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="cimi-statement-ClinicalNote-model.encounter"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code
              value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-encounter-Encounter-model"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="cimi-statement-ClinicalNote-model.interpretation">
      <path value="cimi-statement-ClinicalNote-model.interpretation"/>
      <code>
        <system value="http://ncimeta.nci.nih.gov"/>
        <code value="C0420833"/>
      </code>
      <short
             value="A clinical interpretation of a finding (applies to both assertions and observation)."/>
      <definition
                  value="A clinical interpretation of a finding (applies to both assertions and observation)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="cimi-statement-ClinicalNote-model.interpretation"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Coding"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="extensible"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/ValueSet/observation-interpretation"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="cimi-statement-ClinicalNote-model.relevantTime">
      <path value="cimi-statement-ClinicalNote-model.relevantTime"/>
      <short value="The time or time period that the finding addresses."/>
      <definition
                  value="The time or time period that the finding addresses.
The clinically relevant time is not necessarily when the information is gathered or when a test is carried out, but for example, when a specimen was collected, or the time period referred to by the question. Use a TimePeriod for a measurement or specimen collection continued over a significant period of time (e.g. 24 hour Urine Sodium)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="cimi-statement-ClinicalNote-model.relevantTime"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <type>
        <code
              value="http://hl7.org/fhir/us/odh/StructureDefinition/shr-core-TimePeriod-model"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="cimi-statement-ClinicalNote-model.findingMethod">
      <path value="cimi-statement-ClinicalNote-model.findingMethod"/>
      <short
             value="The technique used to create the finding, for example, the specific imaging technical, lab test code, or assessment vehicle."/>
      <definition
                  value="The technique used to create the finding, for example, the specific imaging technical, lab test code, or assessment vehicle."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="cimi-statement-ClinicalNote-model.findingMethod"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Coding"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="preferred"/>
        <valueSetReference>
          <reference
                     value="http://hl7.org/fhir/us/odh/ValueSet/cimi-statement-FindingMethodVS"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="cimi-statement-ClinicalNote-model.media">
      <path value="cimi-statement-ClinicalNote-model.media"/>
      <short
             value="A file that contains audio, video, image, or similar content."/>
      <definition
                  value="A file that contains audio, video, image, or similar content."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="cimi-statement-ClinicalNote-model.media"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code
              value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-datatypes-Media-model"/>
      </type>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
  </differential>
</StructureDefinition>