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

ClinicalNoteProfile


<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="cimi-statement-ClinicalNote"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
  <p><b>ODH ClinicalNote Profile</b></p>
  <p>An entry concerning a patient where the result is a narrative text.</p>
  <p><b>ODH Mapping Summary</b></p>
  <p><pre>cimi.statement.ClinicalNote maps to DomainResource:
</pre></p>
</div>
  </text>
  <url
       value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-statement-ClinicalNote"/>
  <identifier>
    <system value="http://hl7.org/fhir/us/odh"/>
    <value value="cimi.statement.ClinicalNote"/>
  </identifier>
  <version value="0.1.0"/>
  <name value="ClinicalNoteProfile"/>
  <title value="ODH ClinicalNote Profile"/>
  <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."/>
  <fhirVersion value="3.0.1"/>
  <mapping>
    <identity value="rim"/>
    <uri value="http://hl7.org/v3"/>
    <name value="RIM Mapping"/>
  </mapping>
  <kind value="resource"/>
  <abstract value="true"/>
  <type value="DomainResource"/>
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
  <derivation value="constraint"/>
  <snapshot>
    <element id="DomainResource:cimi-statement-ClinicalNote">
      <path value="DomainResource"/>
      <short value="ODH ClinicalNote Profile"/>
      <definition
                  value="An entry concerning a patient where the result is a narrative text."/>
      <min value="0"/>
      <max value="*"/>
      <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)"/>
      </constraint>
      <constraint>
        <key value="dom-1"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL NOT contain any narrative"/>
        <expression value="contained.text.empty()"/>
        <xpath value="not(parent::f:contained and f:text)"/>
      </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))"/>
      </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"/>
        <expression
                    value="contained.where((&#39;#&#39;+id in %resource.descendants().reference).not()).empty()"/>
        <xpath
               value="not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat(&#39;#&#39;, $id))]))"/>
      </constraint>
      <mapping>
        <identity value="rim"/>
        <map value="Entity. Role, or Act"/>
      </mapping>
    </element>
    <element id="DomainResource:cimi-statement-ClinicalNote.id">
      <path value="DomainResource.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>
        <code value="id"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element id="DomainResource:cimi-statement-ClinicalNote.meta">
      <path value="DomainResource.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 may 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>
      <isSummary value="true"/>
    </element>
    <element id="DomainResource:cimi-statement-ClinicalNote.implicitRules">
      <path value="DomainResource.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."/>
      <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. 

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it&#39;s meaning or interpretation."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.implicitRules"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <isModifier value="true"/>
      <isSummary value="true"/>
    </element>
    <element id="DomainResource:cimi-statement-ClinicalNote.language">
      <path value="DomainResource.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>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueReference>
            <reference value="http://hl7.org/fhir/ValueSet/all-languages"/>
          </valueReference>
        </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="extensible"/>
        <description value="A human language."/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/languages"/>
        </valueSetReference>
      </binding>
    </element>
    <element id="DomainResource:cimi-statement-ClinicalNote.text">
      <path value="DomainResource.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 may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety."/>
      <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 in formation is added later."/>
      <alias value="narrative"/>
      <alias value="html"/>
      <alias value="xhtml"/>
      <alias value="display"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Narrative"/>
      </type>
      <condition value="dom-1"/>
      <mapping>
        <identity value="rim"/>
        <map value="Act.text?"/>
      </mapping>
    </element>
    <element id="DomainResource:cimi-statement-ClinicalNote.contained">
      <path value="DomainResource.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."/>
      <alias value="inline resources"/>
      <alias value="anonymous resources"/>
      <alias value="contained resources"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Resource"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DomainResource:cimi-statement-ClinicalNote.extension">
      <path value="DomainResource.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 resource. 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."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="2"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="DomainResource:cimi-statement-ClinicalNote.extension:personofrecord">
      <path value="DomainResource.extension"/>
      <sliceName value="personofrecord"/>
      <definition value="The person this entry belongs to."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-core-PersonOfRecord-extension"/>
      </type>
    </element>
    <element id="DomainResource:cimi-statement-ClinicalNote.extension:recorded">
      <path value="DomainResource.extension"/>
      <sliceName value="recorded"/>
      <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"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-core-Recorded-extension"/>
      </type>
    </element>
    <element id="DomainResource:cimi-statement-ClinicalNote.extension:signed">
      <path value="DomainResource.extension"/>
      <sliceName value="signed"/>
      <definition
                  value="Provenance information specific to the signing of the clinical statement."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-core-Signed-extension"/>
      </type>
    </element>
    <element
             id="DomainResource:cimi-statement-ClinicalNote.extension:additionaltext">
      <path value="DomainResource.extension"/>
      <sliceName value="additionaltext"/>
      <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"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-core-AdditionalText-extension"/>
      </type>
    </element>
    <element
             id="DomainResource:cimi-statement-ClinicalNote.extension:contextcode">
      <path value="DomainResource.extension"/>
      <sliceName value="contextcode"/>
      <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"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-statement-ContextCode-extension"/>
      </type>
    </element>
    <element
             id="DomainResource:cimi-statement-ClinicalNote.extension:contextcode.id">
      <path value="DomainResource.extension.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="DomainResource:cimi-statement-ClinicalNote.extension:contextcode.extension:extension">
      <path value="DomainResource.extension.extension"/>
      <sliceName value="extension"/>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
    </element>
    <element
             id="DomainResource:cimi-statement-ClinicalNote.extension:contextcode.url">
      <path value="DomainResource.extension.url"/>
      <representation value="xmlAttr"/>
      <short value="identifies the meaning of the extension"/>
      <definition
                  value="Source of the definition for the extension code - a logical name or a URL."/>
      <comment
               value="The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.url"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <fixedUri
                value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-statement-ContextCode-extension"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="DomainResource:cimi-statement-ClinicalNote.extension:contextcode.valueCodeableConcept">
      <path value="DomainResource.extension.valueCodeableConcept"/>
      <short value="Value of extension"/>
      <definition
                  value="Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list)."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.value[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="DomainResource:cimi-statement-ClinicalNote.extension:contextcode.valueCodeableConcept.id">
      <path value="DomainResource.extension.valueCodeableConcept.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="DomainResource:cimi-statement-ClinicalNote.extension:contextcode.valueCodeableConcept.extension">
      <path value="DomainResource.extension.valueCodeableConcept.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."/>
      <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>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="DomainResource:cimi-statement-ClinicalNote.extension:contextcode.valueCodeableConcept.coding">
      <path value="DomainResource.extension.valueCodeableConcept.coding"/>
      <slicing id="1">
        <discriminator>
          <type value="value"/>
          <path value="code"/>
        </discriminator>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Code defined by a terminology system"/>
      <definition value="A reference to a code defined by a terminology system."/>
      <comment
               value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true."/>
      <requirements
                    value="Allows for translations and alternate encodings within a code system.  Also supports communication of the same instance to systems requiring different encodings."/>
      <min value="1"/>
      <max value="*"/>
      <type>
        <code value="Coding"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.1-8, C*E.10-22"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="union(., ./translation)"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/>
      </mapping>
    </element>
    <element
             id="DomainResource:cimi-statement-ClinicalNote.extension:contextcode.valueCodeableConcept.coding:Fixed_424975005">
      <path value="DomainResource.extension.valueCodeableConcept.coding"/>
      <sliceName value="Fixed_424975005"/>
      <short value="Record Entity"/>
      <definition value="Record Entity"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Coding"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element
             id="DomainResource:cimi-statement-ClinicalNote.extension:contextcode.valueCodeableConcept.coding:Fixed_424975005.id">
      <path value="DomainResource.extension.valueCodeableConcept.coding.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="DomainResource:cimi-statement-ClinicalNote.extension:contextcode.valueCodeableConcept.coding:Fixed_424975005.extension">
      <path
            value="DomainResource.extension.valueCodeableConcept.coding.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."/>
      <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>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="DomainResource:cimi-statement-ClinicalNote.extension:contextcode.valueCodeableConcept.coding:Fixed_424975005.system">
      <path value="DomainResource.extension.valueCodeableConcept.coding.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="0"/>
      <max value="1"/>
      <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="DomainResource:cimi-statement-ClinicalNote.extension:contextcode.valueCodeableConcept.coding:Fixed_424975005.version">
      <path value="DomainResource.extension.valueCodeableConcept.coding.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"/>
      <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="DomainResource:cimi-statement-ClinicalNote.extension:contextcode.valueCodeableConcept.coding:Fixed_424975005.code">
      <path value="DomainResource.extension.valueCodeableConcept.coding.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="0"/>
      <max value="1"/>
      <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="DomainResource:cimi-statement-ClinicalNote.extension:contextcode.valueCodeableConcept.coding:Fixed_424975005.display">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/>
      </extension>
      <path value="DomainResource.extension.valueCodeableConcept.coding.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"/>
      <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="DomainResource:cimi-statement-ClinicalNote.extension:contextcode.valueCodeableConcept.coding:Fixed_424975005.userSelected">
      <path
            value="DomainResource.extension.valueCodeableConcept.coding.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"/>
      <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="DomainResource:cimi-statement-ClinicalNote.extension:contextcode.valueCodeableConcept.text">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/>
      </extension>
      <path value="DomainResource.extension.valueCodeableConcept.text"/>
      <short value="Plain text representation of the concept"/>
      <definition
                  value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user."/>
      <comment
               value="Very often the text is the same as a displayName of one of the codings."/>
      <requirements
                    value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.9. But note many systems use C*E.2 for this"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./originalText[mediaType/code=&quot;text/plain&quot;]/data"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"/>
      </mapping>
    </element>
    <element
             id="DomainResource:cimi-statement-ClinicalNote.extension:statementtopic">
      <path value="DomainResource.extension"/>
      <sliceName value="statementtopic"/>
      <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"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-topic-StatementTopic-extension"/>
      </type>
    </element>
    <element id="DomainResource:cimi-statement-ClinicalNote.extension:encounter">
      <path value="DomainResource.extension"/>
      <sliceName value="encounter"/>
      <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"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-encounter-Encounter-extension"/>
      </type>
    </element>
    <element
             id="DomainResource:cimi-statement-ClinicalNote.extension:interpretation">
      <path value="DomainResource.extension"/>
      <sliceName value="interpretation"/>
      <definition
                  value="A clinical interpretation of a finding (applies to both assertions and observation)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-statement-Interpretation-extension"/>
      </type>
    </element>
    <element
             id="DomainResource:cimi-statement-ClinicalNote.extension:relevanttime">
      <path value="DomainResource.extension"/>
      <sliceName value="relevanttime"/>
      <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"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-statement-RelevantTime-extension"/>
      </type>
    </element>
    <element
             id="DomainResource:cimi-statement-ClinicalNote.extension:findingmethod">
      <path value="DomainResource.extension"/>
      <sliceName value="findingmethod"/>
      <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"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-statement-FindingMethod-extension"/>
      </type>
    </element>
    <element id="DomainResource:cimi-statement-ClinicalNote.extension:media">
      <path value="DomainResource.extension"/>
      <sliceName value="media"/>
      <definition
                  value="A file that contains audio, video, image, or similar content."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-datatypes-Media-extension"/>
      </type>
    </element>
    <element id="DomainResource:cimi-statement-ClinicalNote.modifierExtension">
      <path value="DomainResource.modifierExtension"/>
      <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="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. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions."/>
      <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="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="DomainResource:cimi-statement-ClinicalNote">
      <path value="DomainResource"/>
      <short value="ODH ClinicalNote Profile"/>
      <definition
                  value="An entry concerning a patient where the result is a narrative text."/>
    </element>
    <element id="DomainResource:cimi-statement-ClinicalNote.extension">
      <path value="DomainResource.extension"/>
      <min value="2"/>
      <max value="*"/>
    </element>
    <element
             id="DomainResource:cimi-statement-ClinicalNote.extension:personofrecord">
      <path value="DomainResource.extension"/>
      <sliceName value="personofrecord"/>
      <definition value="The person this entry belongs to."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-core-PersonOfRecord-extension"/>
      </type>
    </element>
    <element id="DomainResource:cimi-statement-ClinicalNote.extension:recorded">
      <path value="DomainResource.extension"/>
      <sliceName value="recorded"/>
      <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"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-core-Recorded-extension"/>
      </type>
    </element>
    <element id="DomainResource:cimi-statement-ClinicalNote.extension:signed">
      <path value="DomainResource.extension"/>
      <sliceName value="signed"/>
      <definition
                  value="Provenance information specific to the signing of the clinical statement."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-core-Signed-extension"/>
      </type>
    </element>
    <element
             id="DomainResource:cimi-statement-ClinicalNote.extension:additionaltext">
      <path value="DomainResource.extension"/>
      <sliceName value="additionaltext"/>
      <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"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-core-AdditionalText-extension"/>
      </type>
    </element>
    <element
             id="DomainResource:cimi-statement-ClinicalNote.extension:contextcode">
      <path value="DomainResource.extension"/>
      <sliceName value="contextcode"/>
      <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"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-statement-ContextCode-extension"/>
      </type>
    </element>
    <element
             id="DomainResource:cimi-statement-ClinicalNote.extension:contextcode.valueCodeableConcept">
      <path value="DomainResource.extension.valueCodeableConcept"/>
    </element>
    <element
             id="DomainResource:cimi-statement-ClinicalNote.extension:contextcode.valueCodeableConcept.coding">
      <path value="DomainResource.extension.valueCodeableConcept.coding"/>
      <slicing id="1">
        <discriminator>
          <type value="value"/>
          <path value="code"/>
        </discriminator>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <min value="1"/>
      <max value="*"/>
    </element>
    <element
             id="DomainResource:cimi-statement-ClinicalNote.extension:contextcode.valueCodeableConcept.coding:Fixed_424975005">
      <path value="DomainResource.extension.valueCodeableConcept.coding"/>
      <sliceName value="Fixed_424975005"/>
      <short value="Record Entity"/>
      <definition value="Record Entity"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Coding"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element
             id="DomainResource:cimi-statement-ClinicalNote.extension:contextcode.valueCodeableConcept.coding:Fixed_424975005.system">
      <path value="DomainResource.extension.valueCodeableConcept.coding.system"/>
      <fixedUri value="http://snomed.info/sct"/>
    </element>
    <element
             id="DomainResource:cimi-statement-ClinicalNote.extension:contextcode.valueCodeableConcept.coding:Fixed_424975005.code">
      <path value="DomainResource.extension.valueCodeableConcept.coding.code"/>
      <fixedCode value="424975005"/>
    </element>
    <element
             id="DomainResource:cimi-statement-ClinicalNote.extension:statementtopic">
      <path value="DomainResource.extension"/>
      <sliceName value="statementtopic"/>
      <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"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-topic-StatementTopic-extension"/>
      </type>
    </element>
    <element id="DomainResource:cimi-statement-ClinicalNote.extension:encounter">
      <path value="DomainResource.extension"/>
      <sliceName value="encounter"/>
      <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"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-encounter-Encounter-extension"/>
      </type>
    </element>
    <element
             id="DomainResource:cimi-statement-ClinicalNote.extension:interpretation">
      <path value="DomainResource.extension"/>
      <sliceName value="interpretation"/>
      <definition
                  value="A clinical interpretation of a finding (applies to both assertions and observation)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-statement-Interpretation-extension"/>
      </type>
    </element>
    <element
             id="DomainResource:cimi-statement-ClinicalNote.extension:relevanttime">
      <path value="DomainResource.extension"/>
      <sliceName value="relevanttime"/>
      <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"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-statement-RelevantTime-extension"/>
      </type>
    </element>
    <element
             id="DomainResource:cimi-statement-ClinicalNote.extension:findingmethod">
      <path value="DomainResource.extension"/>
      <sliceName value="findingmethod"/>
      <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"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-statement-FindingMethod-extension"/>
      </type>
    </element>
    <element id="DomainResource:cimi-statement-ClinicalNote.extension:media">
      <path value="DomainResource.extension"/>
      <sliceName value="media"/>
      <definition
                  value="A file that contains audio, video, image, or similar content."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/odh/StructureDefinition/cimi-datatypes-Media-extension"/>
      </type>
    </element>
  </differential>
</StructureDefinition>