PACIO Transitions of Care Implementation Guide
1.0.0-ballot - STU 1 Ballot United States of America flag

This page is part of the PACIO Transitions of Care Implementation Guide (v1.0.0-ballot: STU 1 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. No current official version has been published yet. For a full list of available versions, see the Directory of published versions

Resource Profile: TOCComposition - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 2

Definitions for the TOC-Composition resource profile.

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

0. Composition
Definition

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

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

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

Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. Composition.implicitRules
Definition

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

ShortA set of rules under which this content was created
Comments

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

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

The base language in which the resource is written.

ShortLanguage of the resource content
Comments

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

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

A human language.

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

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

ShortVersion-specific identifier for composition
Comments

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

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

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

ShortExtensions that cannot be ignored
Comments

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

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

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


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

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

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

ShortVersion-independent identifier for the Composition
Comments

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

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

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

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

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

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

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

The workflow/clinical status of the composition.

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

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

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

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

ShortKind of composition (LOINC if possible)
Comments

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

Control1..1
BindingUnless not suitable, these codes SHALL be taken from The codes SHOULD be taken from FHIRDocumentTypeCodeshttp://hl7.org/fhir/ValueSet/doc-typecodes
(extensible to http://hl7.org/fhir/ValueSet/doc-typecodes)
TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Requirements

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

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

A categorization for the type of the composition - helps for indexing and searching. This may be implied by or derived from the code specified in the Composition Type.

ShortCategorization of Composition
Comments

This is a metadata field from XDS/MHD.

Control0..1*
BindingFor example codes, see DocumentClassValueSethttp://hl7.org/fhir/ValueSet/document-classcodes
(example to http://hl7.org/fhir/ValueSet/document-classcodes)

High-level kind of a clinical document at a macro level.

TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Requirements

Helps humans to assess whether the composition is of interest when viewing an index of compositions or documents.

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

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

ShortWho and/or what the composition is about
Comments

For clinical documents, this is usually the patient.

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

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

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

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

ShortContext of the Composition
Control0..1
TypeReference(US Core Encounter Profile, Encounter)
Is Modifierfalse
Summarytrue
Requirements

Provides context for the composition and supports searching.

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

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

ShortComposition editing time
Comments

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

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

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


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

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

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

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

Identifies who is responsible for the content.

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

Official human-readable label for the composition.

ShortHuman Readable name/title
Comments

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

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

The code specifying the level of confidentiality of the Composition.

ShortAs defined by affinity domain
Comments

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

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

Codes specifying the level of confidentiality of the composition.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. Composition.custodian
Definition

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

ShortOrganization which maintains the composition
Comments

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

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

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

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

The root of the sections that make up the composition.

ShortComposition is broken into sections
Control40..*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
SlicingThis element introduces a set of slices on Composition.section. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ code
  • 34. Composition.section.modifierExtension
    Definition

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

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

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

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


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

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

    A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

    ShortText summary of the section, for human interpretation
    Comments

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

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

    The root of the sections that make up the composition.

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

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

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

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

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


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

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

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

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

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

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

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

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

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

    ShortClassification of section (recommended)
    Comments

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

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

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

    Classification of a section of a composition/document.

    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Requirements

    Provides computable standardized labels to topics within the document.

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

    A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

    ShortText summary of the section, for human interpretation
    Comments

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

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

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

    ShortA reference to data that supports this section
    Comments

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

    Control0..*
    This element is affected by the following invariants: cmp-2
    TypeReference(ADI Personal Advance Care Plan Composition, Resource)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    50. Composition.section:allergies
    Slice Nameallergies
    Definition

    The root of the sections that make up the composition.

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

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

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

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

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


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

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

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

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

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

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

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

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

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

    ShortClassification of section (recommended)
    Comments

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

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

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

    Classification of a section of a composition/document.

    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Requirements

    Provides computable standardized labels to topics within the document.

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

    A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

    ShortText summary of the section, for human interpretation
    Comments

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

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

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

    ShortA reference to data that supports this section
    Comments

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

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

    The root of the sections that make up the composition.

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

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

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

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

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


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

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

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

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

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

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

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

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

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

    ShortClassification of section (recommended)
    Comments

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

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

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

    Classification of a section of a composition/document.

    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Requirements

    Provides computable standardized labels to topics within the document.

    Pattern Value{
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "54511-1",
        "display" : "Behavior"
      }]
    }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    70. Composition.section:behavioral_health.text
    Definition

    A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

    ShortText summary of the section, for human interpretation
    Comments

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

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

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

    ShortA reference to data that supports this section
    Comments

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

    Control0..*
    This element is affected by the following invariants: cmp-2
    TypeReference(US Core Condition Encounter Diagnosis Profile, US Core Condition Problems and Health Concerns Profile, US Core Simple Observation Profile, Resource)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    74. Composition.section:functional_status
    Slice Namefunctional_status
    Definition

    The root of the sections that make up the composition.

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

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

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

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

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


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

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

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

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

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

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

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

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

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

    ShortClassification of section (recommended)
    Comments

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

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

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

    Classification of a section of a composition/document.

    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Requirements

    Provides computable standardized labels to topics within the document.

    Pattern Value{
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "54522-8",
        "display" : "Functional status"
      }]
    }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    82. Composition.section:functional_status.text
    Definition

    A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

    ShortText summary of the section, for human interpretation
    Comments

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

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

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

    ShortA reference to data that supports this section
    Comments

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

    Control0..*
    This element is affected by the following invariants: cmp-2
    TypeReference(Observation, Personal Functioning and Engagement Use of Device, Personal Functioning and Engagement Narrative History of Status, Resource)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    86. Composition.section:immunizations
    Slice Nameimmunizations
    Definition

    The root of the sections that make up the composition.

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

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

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

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

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


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

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

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

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

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

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

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

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

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

    ShortClassification of section (recommended)
    Comments

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

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

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

    Classification of a section of a composition/document.

    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Requirements

    Provides computable standardized labels to topics within the document.

    Pattern Value{
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "82593-5",
        "display" : "Immunization summary report"
      }]
    }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    94. Composition.section:immunizations.text
    Definition

    A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

    ShortText summary of the section, for human interpretation
    Comments

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

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

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

    ShortA reference to data that supports this section
    Comments

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

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

    The root of the sections that make up the composition.

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

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

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

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

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


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

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

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

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

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

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

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

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

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

    ShortClassification of section (recommended)
    Comments

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

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

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

    Classification of a section of a composition/document.

    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Requirements

    Provides computable standardized labels to topics within the document.

    Pattern Value{
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "59271-7",
        "display" : "Hospital discharge summary panel"
      }]
    }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    106. Composition.section:instructions.text
    Definition

    A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

    ShortText summary of the section, for human interpretation
    Comments

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

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

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

    ShortA reference to data that supports this section
    Comments

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

    Control0..*
    This element is affected by the following invariants: cmp-2
    TypeReference(US Core DiagnosticReport Profile for Report and Note Exchange, US Core DocumentReference Profile, Resource)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    110. Composition.section:medication_equipment
    Slice Namemedication_equipment
    Definition

    The root of the sections that make up the composition.

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

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

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

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

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


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

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

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

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

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

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

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

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

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

    ShortClassification of section (recommended)
    Comments

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

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

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

    Classification of a section of a composition/document.

    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Requirements

    Provides computable standardized labels to topics within the document.

    Pattern Value{
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "57829-4",
        "display" : "Prescription for medical equipment or product"
      }]
    }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    118. Composition.section:medication_equipment.text
    Definition

    A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

    ShortText summary of the section, for human interpretation
    Comments

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

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

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

    ShortA reference to data that supports this section
    Comments

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

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

    The root of the sections that make up the composition.

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

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

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

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

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


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

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

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

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

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

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

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

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

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

    ShortClassification of section (recommended)
    Comments

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

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

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

    Classification of a section of a composition/document.

    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Requirements

    Provides computable standardized labels to topics within the document.

    Pattern Value{
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "52471-0",
        "display" : "Medications"
      }]
    }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    130. Composition.section:medications.text
    Definition

    A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

    ShortText summary of the section, for human interpretation
    Comments

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

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

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

    ShortA reference to data that supports this section
    Comments

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

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

    The root of the sections that make up the composition.

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

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

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

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

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


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

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

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

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

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

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

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

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

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

    ShortClassification of section (recommended)
    Comments

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

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

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

    Classification of a section of a composition/document.

    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Requirements

    Provides computable standardized labels to topics within the document.

    Pattern Value{
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "74449-0",
        "display" : "Patient plan of care - recommended IHE set"
      }]
    }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    142. Composition.section:plan_of_care.text
    Definition

    A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

    ShortText summary of the section, for human interpretation
    Comments

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

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

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

    ShortA reference to data that supports this section
    Comments

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

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

    The root of the sections that make up the composition.

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

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

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

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

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


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

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

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

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

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

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

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

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

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

    ShortClassification of section (recommended)
    Comments

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

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

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

    Classification of a section of a composition/document.

    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Requirements

    Provides computable standardized labels to topics within the document.

    Pattern Value{
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "46019-6",
        "display" : "Diseases or conditions Set"
      }]
    }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    154. Composition.section:problems.text
    Definition

    A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

    ShortText summary of the section, for human interpretation
    Comments

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

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

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

    ShortA reference to data that supports this section
    Comments

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

    Control0..*
    This element is affected by the following invariants: cmp-2
    TypeReference(US Core Condition Encounter Diagnosis Profile, US Core Condition Problems and Health Concerns Profile, US Core Simple Observation Profile, Resource)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    158. Composition.section:procedures
    Slice Nameprocedures
    Definition

    The root of the sections that make up the composition.

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

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

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

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

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


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

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

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

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

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

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

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

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

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

    ShortClassification of section (recommended)
    Comments

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

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

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

    Classification of a section of a composition/document.

    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Requirements

    Provides computable standardized labels to topics within the document.

    Pattern Value{
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "28570-0",
        "display" : "Procedure note"
      }]
    }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    166. Composition.section:procedures.text
    Definition

    A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

    ShortText summary of the section, for human interpretation
    Comments

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

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

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

    ShortA reference to data that supports this section
    Comments

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

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

    The root of the sections that make up the composition.

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

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

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

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

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


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

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

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

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

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

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

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

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

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

    ShortClassification of section (recommended)
    Comments

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

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

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

    Classification of a section of a composition/document.

    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Requirements

    Provides computable standardized labels to topics within the document.

    Pattern Value{
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "42349-1",
        "display" : "Reason for referral (narrative)"
      }]
    }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    178. Composition.section:reason_for_referral.text
    Definition

    A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

    ShortText summary of the section, for human interpretation
    Comments

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

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

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

    ShortA reference to data that supports this section
    Comments

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

    Control0..*
    This element is affected by the following invariants: cmp-2
    TypeReference(US Core Condition Problems and Health Concerns Profile, US Core Condition Encounter Diagnosis Profile, US Core Procedure Profile, Observation, ImmunizationRecommendation, Discharge Summary, US Core Encounter Profile, Resource)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    182. Composition.section:reason_for_visit
    Slice Namereason_for_visit
    Definition

    The root of the sections that make up the composition.

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

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

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

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

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


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

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

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

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

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

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

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

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

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

    ShortClassification of section (recommended)
    Comments

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

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

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

    Classification of a section of a composition/document.

    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Requirements

    Provides computable standardized labels to topics within the document.

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

    A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

    ShortText summary of the section, for human interpretation
    Comments

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

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

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

    ShortA reference to data that supports this section
    Comments

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

    Control0..*
    This element is affected by the following invariants: cmp-2
    TypeReference(US Core Condition Problems and Health Concerns Profile, US Core Condition Encounter Diagnosis Profile, US Core Procedure Profile, Observation, ImmunizationRecommendation, Discharge Summary, US Core Encounter Profile, Resource)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    194. Composition.section:results
    Slice Nameresults
    Definition

    The root of the sections that make up the composition.

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

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

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

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

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


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

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

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

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

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

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

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

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

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

    ShortClassification of section (recommended)
    Comments

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

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

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

    Classification of a section of a composition/document.

    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Requirements

    Provides computable standardized labels to topics within the document.

    Pattern Value{
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "19146-0",
        "display" : "Referral lab test results"
      }]
    }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    202. Composition.section:results.text
    Definition

    A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

    ShortText summary of the section, for human interpretation
    Comments

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

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

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

    ShortA reference to data that supports this section
    Comments

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

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

    The root of the sections that make up the composition.

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

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

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

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

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


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

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

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

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

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

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

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

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

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

    ShortClassification of section (recommended)
    Comments

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

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

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

    Classification of a section of a composition/document.

    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Requirements

    Provides computable standardized labels to topics within the document.

    Pattern Value{
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "10166-7",
        "display" : "History of Social function Narrative"
      }]
    }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    214. Composition.section:social_history.text
    Definition

    A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

    ShortText summary of the section, for human interpretation
    Comments

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

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

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

    ShortA reference to data that supports this section
    Comments

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

    Control0..*
    This element is affected by the following invariants: cmp-2
    TypeReference(US Core Simple Observation Profile, US Core Smoking Status Observation Profile, Composition (IPS), Personal Functioning and Engagement Narrative History of Status, US Core CarePlan Profile, US Core Patient Profile, US Core Coverage Profile, Dental Bundle, Resource)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    218. Composition.section:vital_signs
    Slice Namevital_signs
    Definition

    The root of the sections that make up the composition.

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

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

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

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

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


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

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

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

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

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

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

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

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

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

    ShortClassification of section (recommended)
    Comments

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

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

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

    Classification of a section of a composition/document.

    TypeCodeableConcept
    Is Modifierfalse
    Summaryfalse
    Requirements

    Provides computable standardized labels to topics within the document.

    Pattern Value{
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "LP30605-7",
        "display" : "Vital signs"
      }]
    }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    226. Composition.section:vital_signs.text
    Definition

    A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

    ShortText summary of the section, for human interpretation
    Comments

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

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

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

    ShortA reference to data that supports this section
    Comments

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

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

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

    0. Composition
    2. Composition.language
    Control1..?
    Must Supporttrue
    4. Composition.identifier
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control1..?
    Must Supporttrue
    6. Composition.type
    BindingUnless not suitable, these codes SHALL be taken from FHIRDocumentTypeCodes
    (extensible to http://hl7.org/fhir/ValueSet/doc-typecodes)
    Must Supporttrue
    8. Composition.category
    Control0..1
    Must Supporttrue
    Pattern Value{
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "42348-3"
      }]
    }
    10. Composition.subject
    Control1..?
    TypeReference(US Core Patient Profile)
    Must Supporttrue
    12. Composition.encounter
    TypeReference(US Core Encounter Profile)
    14. Composition.date
    Must Supporttrue
    16. Composition.author
    TypeReference(US Core Practitioner Profile, US Core PractitionerRole Profile, PractitionerRole, US Core Patient Profile, Device, RelatedPerson)
    Must Supporttrue
    Must Support TypesNo must-support rules about the choice of types/profiles
    18. Composition.title
    Must Supporttrue
    20. Composition.confidentiality
    Control0..0
    22. Composition.custodian
    Control1..?
    TypeReference(US Core Organization Profile)
    Must Supporttrue
    24. Composition.section
    Control4..?
    SlicingThis element introduces a set of slices on Composition.section. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ code
    • 26. Composition.section.text
      Control1..?
      Must Supporttrue
      28. Composition.section:advance_directives
      Slice Nameadvance_directives
      ShortAdvance Directives
      Control0..1
      Must Supporttrue
      30. Composition.section:advance_directives.title
      Control1..?
      Must Supporttrue
      32. Composition.section:advance_directives.code
      Control1..?
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "42348-3",
          "display" : "Advance healthcare directives"
        }]
      }
      34. Composition.section:advance_directives.entry
      TypeReference(ADI Personal Advance Care Plan Composition)
      36. Composition.section:allergies
      Slice Nameallergies
      ShortAllergies
      Control1..1
      Must Supporttrue
      38. Composition.section:allergies.title
      Control1..?
      Must Supporttrue
      40. Composition.section:allergies.code
      Control1..?
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "48765-2",
          "display" : "Allergies and adverse reactions Document"
        }]
      }
      42. Composition.section:allergies.entry
      TypeReference(US Core AllergyIntolerance Profile)
      44. Composition.section:behavioral_health
      Slice Namebehavioral_health
      ShortBehavioral Health
      Control0..1
      Must Supporttrue
      46. Composition.section:behavioral_health.title
      Control1..?
      Must Supporttrue
      48. Composition.section:behavioral_health.code
      Control1..?
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "54511-1",
          "display" : "Behavior"
        }]
      }
      50. Composition.section:behavioral_health.entry
      TypeReference(US Core Condition Encounter Diagnosis Profile, US Core Condition Problems and Health Concerns Profile, US Core Simple Observation Profile)
      52. Composition.section:functional_status
      Slice Namefunctional_status
      ShortFunctional Status
      Control0..1
      Must Supporttrue
      54. Composition.section:functional_status.title
      Control1..?
      Must Supporttrue
      56. Composition.section:functional_status.code
      Control1..?
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "54522-8",
          "display" : "Functional status"
        }]
      }
      58. Composition.section:functional_status.entry
      TypeReference(Observation, Personal Functioning and Engagement Use of Device, Personal Functioning and Engagement Narrative History of Status)
      60. Composition.section:immunizations
      Slice Nameimmunizations
      ShortImmunizations
      Control0..1
      Must Supporttrue
      62. Composition.section:immunizations.title
      Control1..?
      Must Supporttrue
      64. Composition.section:immunizations.code
      Control1..?
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "82593-5",
          "display" : "Immunization summary report"
        }]
      }
      66. Composition.section:immunizations.entry
      TypeReference(US Core Immunization Profile)
      68. Composition.section:instructions
      Slice Nameinstructions
      ShortDischarge Instructions
      Control0..1
      Must Supporttrue
      70. Composition.section:instructions.title
      Control1..?
      Must Supporttrue
      72. Composition.section:instructions.code
      Control1..?
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "59271-7",
          "display" : "Hospital discharge summary panel"
        }]
      }
      74. Composition.section:instructions.entry
      TypeReference(US Core DiagnosticReport Profile for Report and Note Exchange, US Core DocumentReference Profile)
      76. Composition.section:medication_equipment
      Slice Namemedication_equipment
      ShortMedication Equipment
      Control0..1
      Must Supporttrue
      78. Composition.section:medication_equipment.title
      Control1..?
      Must Supporttrue
      80. Composition.section:medication_equipment.code
      Control1..?
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "57829-4",
          "display" : "Prescription for medical equipment or product"
        }]
      }
      82. Composition.section:medication_equipment.entry
      TypeReference(Device)
      84. Composition.section:medications
      Slice Namemedications
      ShortMedications
      Control1..1
      Must Supporttrue
      86. Composition.section:medications.title
      Control1..?
      Must Supporttrue
      88. Composition.section:medications.code
      Control1..?
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "52471-0",
          "display" : "Medications"
        }]
      }
      90. Composition.section:medications.entry
      TypeReference(List)
      92. Composition.section:plan_of_care
      Slice Nameplan_of_care
      ShortPlan of Care
      Control0..1
      Must Supporttrue
      94. Composition.section:plan_of_care.title
      Control1..?
      Must Supporttrue
      96. Composition.section:plan_of_care.code
      Control1..?
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "74449-0",
          "display" : "Patient plan of care - recommended IHE set"
        }]
      }
      98. Composition.section:plan_of_care.entry
      TypeReference(US Core CarePlan Profile)
      100. Composition.section:problems
      Slice Nameproblems
      ShortProblem
      Control1..1
      Must Supporttrue
      102. Composition.section:problems.title
      Control1..?
      Must Supporttrue
      104. Composition.section:problems.code
      Control1..?
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "46019-6",
          "display" : "Diseases or conditions Set"
        }]
      }
      106. Composition.section:problems.entry
      TypeReference(US Core Condition Encounter Diagnosis Profile, US Core Condition Problems and Health Concerns Profile, US Core Simple Observation Profile)
      108. Composition.section:procedures
      Slice Nameprocedures
      ShortProcedures
      Control0..1
      Must Supporttrue
      110. Composition.section:procedures.title
      Control1..?
      Must Supporttrue
      112. Composition.section:procedures.code
      Control1..?
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "28570-0",
          "display" : "Procedure note"
        }]
      }
      114. Composition.section:procedures.entry
      TypeReference(US Core Procedure Profile)
      116. Composition.section:reason_for_referral
      Slice Namereason_for_referral
      ShortReason for Referral
      Control0..1
      Must Supporttrue
      118. Composition.section:reason_for_referral.title
      Control1..?
      Must Supporttrue
      120. Composition.section:reason_for_referral.code
      Control1..?
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "42349-1",
          "display" : "Reason for referral (narrative)"
        }]
      }
      122. Composition.section:reason_for_referral.entry
      TypeReference(US Core Condition Problems and Health Concerns Profile, US Core Condition Encounter Diagnosis Profile, US Core Procedure Profile, Observation, ImmunizationRecommendation, Discharge Summary, US Core Encounter Profile)
      124. Composition.section:reason_for_visit
      Slice Namereason_for_visit
      ShortReason for Visit (Ambulatory)
      Control0..1
      Must Supporttrue
      126. Composition.section:reason_for_visit.title
      Control1..?
      Must Supporttrue
      128. Composition.section:reason_for_visit.code
      Control1..?
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "29299-5",
          "display" : "Reason for visit Narrative"
        }]
      }
      130. Composition.section:reason_for_visit.entry
      TypeReference(US Core Condition Problems and Health Concerns Profile, US Core Condition Encounter Diagnosis Profile, US Core Procedure Profile, Observation, ImmunizationRecommendation, Discharge Summary, US Core Encounter Profile)
      132. Composition.section:results
      Slice Nameresults
      ShortRecent Test Results
      Control1..1
      Must Supporttrue
      134. Composition.section:results.title
      Control1..?
      Must Supporttrue
      136. Composition.section:results.code
      Control1..?
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "19146-0",
          "display" : "Referral lab test results"
        }]
      }
      138. Composition.section:results.entry
      TypeReference(US Core Observation Clinical Result Profile)
      140. Composition.section:social_history
      Slice Namesocial_history
      ShortSocial History
      Control0..1
      Must Supporttrue
      142. Composition.section:social_history.title
      Control1..?
      Must Supporttrue
      144. Composition.section:social_history.code
      Control1..?
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "10166-7",
          "display" : "History of Social function Narrative"
        }]
      }
      146. Composition.section:social_history.entry
      TypeReference(US Core Simple Observation Profile, US Core Smoking Status Observation Profile, Composition (IPS), Personal Functioning and Engagement Narrative History of Status, US Core CarePlan Profile, US Core Patient Profile, US Core Coverage Profile, Dental Bundle)
      148. Composition.section:vital_signs
      Slice Namevital_signs
      ShortVital Signs
      Control0..1
      Must Supporttrue
      150. Composition.section:vital_signs.title
      Control1..?
      Must Supporttrue
      152. Composition.section:vital_signs.code
      Control1..?
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "LP30605-7",
          "display" : "Vital signs"
        }]
      }
      154. Composition.section:vital_signs.entry
      TypeReference(US Core Vital Signs Profile)

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

      0. Composition
      Definition

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

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

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

      Control0..*
      Is Modifierfalse
      Summaryfalse
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
      dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
      dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. Composition.id
      Definition

      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

      ShortLogical id of this artifact
      Comments

      The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

      Control0..1
      Typeid
      Is Modifierfalse
      Summarytrue
      4. Composition.meta
      Definition

      The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

      ShortMetadata about the resource
      Control0..1
      TypeMeta
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. Composition.implicitRules
      Definition

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

      ShortA set of rules under which this content was created
      Comments

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

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

      The base language in which the resource is written.

      ShortLanguage of the resource content
      Comments

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

      Control1..1
      BindingThe codes SHOULD be taken from CommonLanguages
      (preferred to http://hl7.org/fhir/ValueSet/languages)

      A human language.

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

      A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

      ShortText summary of the resource, for human interpretation
      Comments

      Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

      Control0..1
      TypeNarrative
      Is Modifierfalse
      Summaryfalse
      Alternate Namesnarrative, html, xhtml, display
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. Composition.contained
      Definition

      These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

      ShortContained, inline Resources
      Comments

      This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

      Control0..*
      TypeResource
      Is Modifierfalse
      Summaryfalse
      Alternate Namesinline resources, anonymous resources, contained resources
      14. Composition.extension
      Definition

      An Extension

      ShortExtension
      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on Composition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 16. Composition.extension:versionNumber
        Slice NameversionNumber
        Definition

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

        ShortVersion-specific identifier for composition
        Comments

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

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

        May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

        ShortExtensions that cannot be ignored
        Comments

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

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

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

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

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

        ShortVersion-independent identifier for the Composition
        Comments

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

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control1..1
        TypeIdentifier
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        22. Composition.status
        Definition

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

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

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

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

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

        The workflow/clinical status of the composition.

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

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

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

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

        ShortKind of composition (LOINC if possible)
        Comments

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

        Control1..1
        BindingUnless not suitable, these codes SHALL be taken from FHIRDocumentTypeCodes
        (extensible to http://hl7.org/fhir/ValueSet/doc-typecodes)
        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

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

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

        A categorization for the type of the composition - helps for indexing and searching. This may be implied by or derived from the code specified in the Composition Type.

        ShortCategorization of Composition
        Comments

        This is a metadata field from XDS/MHD.

        Control0..1
        BindingFor example codes, see DocumentClassValueSet
        (example to http://hl7.org/fhir/ValueSet/document-classcodes)

        High-level kind of a clinical document at a macro level.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Helps humans to assess whether the composition is of interest when viewing an index of compositions or documents.

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

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

        ShortWho and/or what the composition is about
        Comments

        For clinical documents, this is usually the patient.

        Control1..1
        TypeReference(US Core Patient Profile)
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

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

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

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

        ShortContext of the Composition
        Control0..1
        TypeReference(US Core Encounter Profile)
        Is Modifierfalse
        Summarytrue
        Requirements

        Provides context for the composition and supports searching.

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

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

        ShortComposition editing time
        Comments

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

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

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

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

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

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

        Identifies who is responsible for the content.

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

        Official human-readable label for the composition.

        ShortHuman Readable name/title
        Comments

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

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

        The code specifying the level of confidentiality of the Composition.

        ShortAs defined by affinity domain
        Comments

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

        Control0..0
        BindingThe codes SHALL be taken from v3.ConfidentialityClassification (2014-03-26)
        (required to http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26)

        Codes specifying the level of confidentiality of the composition.

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. Composition.attester
        Definition

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

        ShortAttests to accuracy of composition
        Comments

        Only list each attester once.

        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        Requirements

        Identifies responsibility for the accuracy of the composition content.

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

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        44. Composition.attester.extension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional content defined by implementations
        Comments

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

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        46. Composition.attester.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

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

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

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

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

        The type of attestation the authenticator offers.

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

        The way in which a person authenticated a composition.

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

        Indicates the level of authority of the attestation.

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

        When the composition was attested by the party.

        ShortWhen the composition was attested
        Control0..1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Requirements

        Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).

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

        Who attested the composition in the specified way.

        ShortWho attested the composition
        Control0..1
        TypeReference(Patient, RelatedPerson, Practitioner, PractitionerRole, Organization)
        Is Modifierfalse
        Summaryfalse
        Requirements

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

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

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

        ShortOrganization which maintains the composition
        Comments

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

        Control1..1
        TypeReference(US Core Organization Profile)
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

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

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

        Relationships that this composition has with other compositions or documents that already exist.

        ShortRelationships to other compositions/documents
        Comments

        A document is a version specific composition.

        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        58. Composition.relatesTo.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        60. Composition.relatesTo.extension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional content defined by implementations
        Comments

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

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        62. Composition.relatesTo.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

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

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

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

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

        The type of relationship that this composition has with anther composition or document.

        Shortreplaces | transforms | signs | appends
        Comments

        If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.

        Control1..1
        BindingThe codes SHALL be taken from DocumentRelationshipType
        (required to http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1)

        The type of relationship between documents.

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        66. Composition.relatesTo.target[x]
        Definition

        The target composition/document of this relationship.

        ShortTarget of the relationship
        Control1..1
        TypeChoice of: Identifier, Reference(Composition)
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        68. Composition.event
        Definition

        The clinical service, such as a colonoscopy or an appendectomy, being documented.

        ShortThe clinical service(s) being documented
        Comments

        The event needs to be consistent with the type element, though can provide further information if desired.

        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Summarytrue
        Requirements

        Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event.

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

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        72. Composition.event.extension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional content defined by implementations
        Comments

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

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        74. Composition.event.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

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

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

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

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

        This list of codes represents the main clinical acts, such as a colonoscopy or an appendectomy, being documented. In some cases, the event is inherent in the typeCode, such as a "History and Physical Report" in which the procedure being documented is necessarily a "History and Physical" act.

        ShortCode(s) that apply to the event being documented
        Comments

        An event can further specialize the act inherent in the typeCode, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more eventCodes are included, they SHALL NOT conflict with the values inherent in the classCode, practiceSettingCode or typeCode, as such a conflict would create an ambiguous situation. This short list of codes is provided to be used as key words for certain types of queries.

        Control0..*
        BindingFor example codes, see v3 Code System ActCode
        (example to http://terminology.hl7.org/ValueSet/v3-ActCode)

        This list of codes represents the main clinical acts being documented.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        78. Composition.event.period
        Definition

        The period of time covered by the documentation. There is no assertion that the documentation is a complete representation for this period, only that it documents events during this time.

        ShortThe period covered by the documentation
        Control0..1
        TypePeriod
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        80. Composition.event.detail
        Definition

        The description and/or reference of the event(s) being documented. For example, this could be used to document such a colonoscopy or an appendectomy.

        ShortThe event(s) being documented
        Control0..*
        TypeReference(Resource)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        82. Composition.section
        Definition

        The root of the sections that make up the composition.

        ShortComposition is broken into sections
        Control4..*
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
        cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on Composition.section. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ code
        • 84. Composition.section.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          86. Composition.section.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

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

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          88. Composition.section.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

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

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

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

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

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

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

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

          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Requirements

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

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

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

          ShortClassification of section (recommended)
          Comments

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

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

          Control0..1
          BindingFor example codes, see DocumentSectionCodes
          (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

          Classification of a section of a composition/document.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Provides computable standardized labels to topics within the document.

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

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

          ShortWho and/or what authored the section
          Control0..*
          TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
          Is Modifierfalse
          Summaryfalse
          Requirements

          Identifies who is responsible for the content.

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

          The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

          ShortWho/what the section is about, when it is not about the subject of composition
          Comments

          Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

          Control0..1
          TypeReference(Resource)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          98. Composition.section.text
          Definition

          A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

          ShortText summary of the section, for human interpretation
          Comments

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

          Control1..1
          This element is affected by the following invariants: cmp-1
          TypeNarrative
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          100. Composition.section.mode
          Definition

          How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

          Shortworking | snapshot | changes
          Comments

          This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

          Control0..1
          BindingThe codes SHALL be taken from ListMode
          (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

          The processing mode that applies to this section.

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

          Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

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

          Specifies the order applied to the items in the section entries.

          ShortOrder of section entries
          Comments

          Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

          Control0..1
          BindingThe codes SHOULD be taken from ListOrderCodes
          (preferred to http://hl7.org/fhir/ValueSet/list-order)

          What order applies to the items in the entry.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

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

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

          ShortA reference to data that supports this section
          Comments

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

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

          If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

          ShortWhy the section is empty
          Comments

          The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

          Control0..1
          This element is affected by the following invariants: cmp-2
          BindingThe codes SHOULD be taken from ListEmptyReasons
          (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

          If a section is empty, why it is empty.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Allows capturing things like "none exist" or "not asked" which can be important for most lists.

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

          A nested sub-section within this section.

          ShortNested Section
          Comments

          Nested sections are primarily used to help human readers navigate to particular portions of the document.

          Control0..*
          This element is affected by the following invariants: cmp-1
          TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          110. Composition.section:advance_directives
          Slice Nameadvance_directives
          Definition

          The root of the sections that make up the composition.

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

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          114. Composition.section:advance_directives.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

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

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          116. Composition.section:advance_directives.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

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

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

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

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

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

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

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

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

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

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

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

          ShortClassification of section (recommended)
          Comments

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

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

          Control1..1
          BindingFor example codes, see DocumentSectionCodes
          (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

          Classification of a section of a composition/document.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Provides computable standardized labels to topics within the document.

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

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

          ShortWho and/or what authored the section
          Control0..*
          TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
          Is Modifierfalse
          Summaryfalse
          Requirements

          Identifies who is responsible for the content.

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

          The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

          ShortWho/what the section is about, when it is not about the subject of composition
          Comments

          Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

          Control0..1
          TypeReference(Resource)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          126. Composition.section:advance_directives.text
          Definition

          A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

          ShortText summary of the section, for human interpretation
          Comments

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

          Control1..1
          This element is affected by the following invariants: cmp-1
          TypeNarrative
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          128. Composition.section:advance_directives.mode
          Definition

          How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

          Shortworking | snapshot | changes
          Comments

          This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

          Control0..1
          BindingThe codes SHALL be taken from ListMode
          (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

          The processing mode that applies to this section.

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

          Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

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

          Specifies the order applied to the items in the section entries.

          ShortOrder of section entries
          Comments

          Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

          Control0..1
          BindingThe codes SHOULD be taken from ListOrderCodes
          (preferred to http://hl7.org/fhir/ValueSet/list-order)

          What order applies to the items in the entry.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

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

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

          ShortA reference to data that supports this section
          Comments

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

          Control0..*
          This element is affected by the following invariants: cmp-2
          TypeReference(ADI Personal Advance Care Plan Composition)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          134. Composition.section:advance_directives.emptyReason
          Definition

          If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

          ShortWhy the section is empty
          Comments

          The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

          Control0..1
          This element is affected by the following invariants: cmp-2
          BindingThe codes SHOULD be taken from ListEmptyReasons
          (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

          If a section is empty, why it is empty.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Allows capturing things like "none exist" or "not asked" which can be important for most lists.

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

          A nested sub-section within this section.

          ShortNested Section
          Comments

          Nested sections are primarily used to help human readers navigate to particular portions of the document.

          Control0..*
          This element is affected by the following invariants: cmp-1
          TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          138. Composition.section:allergies
          Slice Nameallergies
          Definition

          The root of the sections that make up the composition.

          ShortAllergies
          Control1..1
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          140. Composition.section:allergies.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          142. Composition.section:allergies.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

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

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          144. Composition.section:allergies.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

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

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

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

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

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

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

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

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

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

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

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

          ShortClassification of section (recommended)
          Comments

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

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

          Control1..1
          BindingFor example codes, see DocumentSectionCodes
          (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

          Classification of a section of a composition/document.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Provides computable standardized labels to topics within the document.

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

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

          ShortWho and/or what authored the section
          Control0..*
          TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
          Is Modifierfalse
          Summaryfalse
          Requirements

          Identifies who is responsible for the content.

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

          The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

          ShortWho/what the section is about, when it is not about the subject of composition
          Comments

          Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

          Control0..1
          TypeReference(Resource)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          154. Composition.section:allergies.text
          Definition

          A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

          ShortText summary of the section, for human interpretation
          Comments

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

          Control1..1
          This element is affected by the following invariants: cmp-1
          TypeNarrative
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          156. Composition.section:allergies.mode
          Definition

          How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

          Shortworking | snapshot | changes
          Comments

          This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

          Control0..1
          BindingThe codes SHALL be taken from ListMode
          (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

          The processing mode that applies to this section.

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

          Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

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

          Specifies the order applied to the items in the section entries.

          ShortOrder of section entries
          Comments

          Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

          Control0..1
          BindingThe codes SHOULD be taken from ListOrderCodes
          (preferred to http://hl7.org/fhir/ValueSet/list-order)

          What order applies to the items in the entry.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

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

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

          ShortA reference to data that supports this section
          Comments

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

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

          If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

          ShortWhy the section is empty
          Comments

          The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

          Control0..1
          This element is affected by the following invariants: cmp-2
          BindingThe codes SHOULD be taken from ListEmptyReasons
          (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

          If a section is empty, why it is empty.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Allows capturing things like "none exist" or "not asked" which can be important for most lists.

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

          A nested sub-section within this section.

          ShortNested Section
          Comments

          Nested sections are primarily used to help human readers navigate to particular portions of the document.

          Control0..*
          This element is affected by the following invariants: cmp-1
          TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          166. Composition.section:behavioral_health
          Slice Namebehavioral_health
          Definition

          The root of the sections that make up the composition.

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

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          170. Composition.section:behavioral_health.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

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

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          172. Composition.section:behavioral_health.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

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

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

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

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

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

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

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

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

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

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

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

          ShortClassification of section (recommended)
          Comments

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

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

          Control1..1
          BindingFor example codes, see DocumentSectionCodes
          (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

          Classification of a section of a composition/document.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Provides computable standardized labels to topics within the document.

          Pattern Value{
            "coding" : [{
              "system" : "http://loinc.org",
              "code" : "54511-1",
              "display" : "Behavior"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          178. Composition.section:behavioral_health.author
          Definition

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

          ShortWho and/or what authored the section
          Control0..*
          TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
          Is Modifierfalse
          Summaryfalse
          Requirements

          Identifies who is responsible for the content.

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

          The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

          ShortWho/what the section is about, when it is not about the subject of composition
          Comments

          Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

          Control0..1
          TypeReference(Resource)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          182. Composition.section:behavioral_health.text
          Definition

          A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

          ShortText summary of the section, for human interpretation
          Comments

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

          Control1..1
          This element is affected by the following invariants: cmp-1
          TypeNarrative
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          184. Composition.section:behavioral_health.mode
          Definition

          How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

          Shortworking | snapshot | changes
          Comments

          This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

          Control0..1
          BindingThe codes SHALL be taken from ListMode
          (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

          The processing mode that applies to this section.

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

          Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

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

          Specifies the order applied to the items in the section entries.

          ShortOrder of section entries
          Comments

          Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

          Control0..1
          BindingThe codes SHOULD be taken from ListOrderCodes
          (preferred to http://hl7.org/fhir/ValueSet/list-order)

          What order applies to the items in the entry.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

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

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

          ShortA reference to data that supports this section
          Comments

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

          Control0..*
          This element is affected by the following invariants: cmp-2
          TypeReference(US Core Condition Encounter Diagnosis Profile, US Core Condition Problems and Health Concerns Profile, US Core Simple Observation Profile)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          190. Composition.section:behavioral_health.emptyReason
          Definition

          If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

          ShortWhy the section is empty
          Comments

          The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

          Control0..1
          This element is affected by the following invariants: cmp-2
          BindingThe codes SHOULD be taken from ListEmptyReasons
          (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

          If a section is empty, why it is empty.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Allows capturing things like "none exist" or "not asked" which can be important for most lists.

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

          A nested sub-section within this section.

          ShortNested Section
          Comments

          Nested sections are primarily used to help human readers navigate to particular portions of the document.

          Control0..*
          This element is affected by the following invariants: cmp-1
          TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          194. Composition.section:functional_status
          Slice Namefunctional_status
          Definition

          The root of the sections that make up the composition.

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

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          198. Composition.section:functional_status.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

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

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          200. Composition.section:functional_status.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

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

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

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

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

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

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

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

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

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

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

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

          ShortClassification of section (recommended)
          Comments

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

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

          Control1..1
          BindingFor example codes, see DocumentSectionCodes
          (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

          Classification of a section of a composition/document.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Provides computable standardized labels to topics within the document.

          Pattern Value{
            "coding" : [{
              "system" : "http://loinc.org",
              "code" : "54522-8",
              "display" : "Functional status"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          206. Composition.section:functional_status.author
          Definition

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

          ShortWho and/or what authored the section
          Control0..*
          TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
          Is Modifierfalse
          Summaryfalse
          Requirements

          Identifies who is responsible for the content.

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

          The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

          ShortWho/what the section is about, when it is not about the subject of composition
          Comments

          Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

          Control0..1
          TypeReference(Resource)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          210. Composition.section:functional_status.text
          Definition

          A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

          ShortText summary of the section, for human interpretation
          Comments

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

          Control1..1
          This element is affected by the following invariants: cmp-1
          TypeNarrative
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          212. Composition.section:functional_status.mode
          Definition

          How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

          Shortworking | snapshot | changes
          Comments

          This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

          Control0..1
          BindingThe codes SHALL be taken from ListMode
          (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

          The processing mode that applies to this section.

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

          Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

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

          Specifies the order applied to the items in the section entries.

          ShortOrder of section entries
          Comments

          Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

          Control0..1
          BindingThe codes SHOULD be taken from ListOrderCodes
          (preferred to http://hl7.org/fhir/ValueSet/list-order)

          What order applies to the items in the entry.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

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

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

          ShortA reference to data that supports this section
          Comments

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

          Control0..*
          This element is affected by the following invariants: cmp-2
          TypeReference(Observation, Personal Functioning and Engagement Use of Device, Personal Functioning and Engagement Narrative History of Status)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          218. Composition.section:functional_status.emptyReason
          Definition

          If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

          ShortWhy the section is empty
          Comments

          The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

          Control0..1
          This element is affected by the following invariants: cmp-2
          BindingThe codes SHOULD be taken from ListEmptyReasons
          (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

          If a section is empty, why it is empty.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Allows capturing things like "none exist" or "not asked" which can be important for most lists.

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

          A nested sub-section within this section.

          ShortNested Section
          Comments

          Nested sections are primarily used to help human readers navigate to particular portions of the document.

          Control0..*
          This element is affected by the following invariants: cmp-1
          TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          222. Composition.section:immunizations
          Slice Nameimmunizations
          Definition

          The root of the sections that make up the composition.

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

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          226. Composition.section:immunizations.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

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

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          228. Composition.section:immunizations.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

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

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

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

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

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

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

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

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

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

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

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

          ShortClassification of section (recommended)
          Comments

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

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

          Control1..1
          BindingFor example codes, see DocumentSectionCodes
          (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

          Classification of a section of a composition/document.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Provides computable standardized labels to topics within the document.

          Pattern Value{
            "coding" : [{
              "system" : "http://loinc.org",
              "code" : "82593-5",
              "display" : "Immunization summary report"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          234. Composition.section:immunizations.author
          Definition

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

          ShortWho and/or what authored the section
          Control0..*
          TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
          Is Modifierfalse
          Summaryfalse
          Requirements

          Identifies who is responsible for the content.

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

          The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

          ShortWho/what the section is about, when it is not about the subject of composition
          Comments

          Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

          Control0..1
          TypeReference(Resource)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          238. Composition.section:immunizations.text
          Definition

          A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

          ShortText summary of the section, for human interpretation
          Comments

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

          Control1..1
          This element is affected by the following invariants: cmp-1
          TypeNarrative
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          240. Composition.section:immunizations.mode
          Definition

          How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

          Shortworking | snapshot | changes
          Comments

          This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

          Control0..1
          BindingThe codes SHALL be taken from ListMode
          (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

          The processing mode that applies to this section.

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

          Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

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

          Specifies the order applied to the items in the section entries.

          ShortOrder of section entries
          Comments

          Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

          Control0..1
          BindingThe codes SHOULD be taken from ListOrderCodes
          (preferred to http://hl7.org/fhir/ValueSet/list-order)

          What order applies to the items in the entry.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

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

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

          ShortA reference to data that supports this section
          Comments

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

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

          If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

          ShortWhy the section is empty
          Comments

          The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

          Control0..1
          This element is affected by the following invariants: cmp-2
          BindingThe codes SHOULD be taken from ListEmptyReasons
          (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

          If a section is empty, why it is empty.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Allows capturing things like "none exist" or "not asked" which can be important for most lists.

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

          A nested sub-section within this section.

          ShortNested Section
          Comments

          Nested sections are primarily used to help human readers navigate to particular portions of the document.

          Control0..*
          This element is affected by the following invariants: cmp-1
          TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          250. Composition.section:instructions
          Slice Nameinstructions
          Definition

          The root of the sections that make up the composition.

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

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          254. Composition.section:instructions.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

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

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          256. Composition.section:instructions.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

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

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

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

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

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

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

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

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

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

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

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

          ShortClassification of section (recommended)
          Comments

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

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

          Control1..1
          BindingFor example codes, see DocumentSectionCodes
          (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

          Classification of a section of a composition/document.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Provides computable standardized labels to topics within the document.

          Pattern Value{
            "coding" : [{
              "system" : "http://loinc.org",
              "code" : "59271-7",
              "display" : "Hospital discharge summary panel"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          262. Composition.section:instructions.author
          Definition

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

          ShortWho and/or what authored the section
          Control0..*
          TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
          Is Modifierfalse
          Summaryfalse
          Requirements

          Identifies who is responsible for the content.

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

          The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

          ShortWho/what the section is about, when it is not about the subject of composition
          Comments

          Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

          Control0..1
          TypeReference(Resource)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          266. Composition.section:instructions.text
          Definition

          A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

          ShortText summary of the section, for human interpretation
          Comments

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

          Control1..1
          This element is affected by the following invariants: cmp-1
          TypeNarrative
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          268. Composition.section:instructions.mode
          Definition

          How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

          Shortworking | snapshot | changes
          Comments

          This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

          Control0..1
          BindingThe codes SHALL be taken from ListMode
          (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

          The processing mode that applies to this section.

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

          Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

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

          Specifies the order applied to the items in the section entries.

          ShortOrder of section entries
          Comments

          Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

          Control0..1
          BindingThe codes SHOULD be taken from ListOrderCodes
          (preferred to http://hl7.org/fhir/ValueSet/list-order)

          What order applies to the items in the entry.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

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

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

          ShortA reference to data that supports this section
          Comments

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

          Control0..*
          This element is affected by the following invariants: cmp-2
          TypeReference(US Core DiagnosticReport Profile for Report and Note Exchange, US Core DocumentReference Profile)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          274. Composition.section:instructions.emptyReason
          Definition

          If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

          ShortWhy the section is empty
          Comments

          The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

          Control0..1
          This element is affected by the following invariants: cmp-2
          BindingThe codes SHOULD be taken from ListEmptyReasons
          (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

          If a section is empty, why it is empty.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Allows capturing things like "none exist" or "not asked" which can be important for most lists.

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

          A nested sub-section within this section.

          ShortNested Section
          Comments

          Nested sections are primarily used to help human readers navigate to particular portions of the document.

          Control0..*
          This element is affected by the following invariants: cmp-1
          TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          278. Composition.section:medication_equipment
          Slice Namemedication_equipment
          Definition

          The root of the sections that make up the composition.

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

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          282. Composition.section:medication_equipment.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

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

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          284. Composition.section:medication_equipment.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

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

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

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

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

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

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

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

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

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

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

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

          ShortClassification of section (recommended)
          Comments

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

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

          Control1..1
          BindingFor example codes, see DocumentSectionCodes
          (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

          Classification of a section of a composition/document.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Provides computable standardized labels to topics within the document.

          Pattern Value{
            "coding" : [{
              "system" : "http://loinc.org",
              "code" : "57829-4",
              "display" : "Prescription for medical equipment or product"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          290. Composition.section:medication_equipment.author
          Definition

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

          ShortWho and/or what authored the section
          Control0..*
          TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
          Is Modifierfalse
          Summaryfalse
          Requirements

          Identifies who is responsible for the content.

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

          The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

          ShortWho/what the section is about, when it is not about the subject of composition
          Comments

          Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

          Control0..1
          TypeReference(Resource)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          294. Composition.section:medication_equipment.text
          Definition

          A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

          ShortText summary of the section, for human interpretation
          Comments

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

          Control1..1
          This element is affected by the following invariants: cmp-1
          TypeNarrative
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          296. Composition.section:medication_equipment.mode
          Definition

          How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

          Shortworking | snapshot | changes
          Comments

          This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

          Control0..1
          BindingThe codes SHALL be taken from ListMode
          (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

          The processing mode that applies to this section.

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

          Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

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

          Specifies the order applied to the items in the section entries.

          ShortOrder of section entries
          Comments

          Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

          Control0..1
          BindingThe codes SHOULD be taken from ListOrderCodes
          (preferred to http://hl7.org/fhir/ValueSet/list-order)

          What order applies to the items in the entry.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

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

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

          ShortA reference to data that supports this section
          Comments

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

          Control0..*
          This element is affected by the following invariants: cmp-2
          TypeReference(Device)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          302. Composition.section:medication_equipment.emptyReason
          Definition

          If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

          ShortWhy the section is empty
          Comments

          The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

          Control0..1
          This element is affected by the following invariants: cmp-2
          BindingThe codes SHOULD be taken from ListEmptyReasons
          (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

          If a section is empty, why it is empty.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Allows capturing things like "none exist" or "not asked" which can be important for most lists.

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

          A nested sub-section within this section.

          ShortNested Section
          Comments

          Nested sections are primarily used to help human readers navigate to particular portions of the document.

          Control0..*
          This element is affected by the following invariants: cmp-1
          TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          306. Composition.section:medications
          Slice Namemedications
          Definition

          The root of the sections that make up the composition.

          ShortMedications
          Control1..1
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          308. Composition.section:medications.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          310. Composition.section:medications.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

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

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          312. Composition.section:medications.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

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

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

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

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

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

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

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

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

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

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

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

          ShortClassification of section (recommended)
          Comments

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

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

          Control1..1
          BindingFor example codes, see DocumentSectionCodes
          (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

          Classification of a section of a composition/document.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Provides computable standardized labels to topics within the document.

          Pattern Value{
            "coding" : [{
              "system" : "http://loinc.org",
              "code" : "52471-0",
              "display" : "Medications"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          318. Composition.section:medications.author
          Definition

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

          ShortWho and/or what authored the section
          Control0..*
          TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
          Is Modifierfalse
          Summaryfalse
          Requirements

          Identifies who is responsible for the content.

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

          The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

          ShortWho/what the section is about, when it is not about the subject of composition
          Comments

          Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

          Control0..1
          TypeReference(Resource)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          322. Composition.section:medications.text
          Definition

          A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

          ShortText summary of the section, for human interpretation
          Comments

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

          Control1..1
          This element is affected by the following invariants: cmp-1
          TypeNarrative
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          324. Composition.section:medications.mode
          Definition

          How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

          Shortworking | snapshot | changes
          Comments

          This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

          Control0..1
          BindingThe codes SHALL be taken from ListMode
          (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

          The processing mode that applies to this section.

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

          Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

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

          Specifies the order applied to the items in the section entries.

          ShortOrder of section entries
          Comments

          Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

          Control0..1
          BindingThe codes SHOULD be taken from ListOrderCodes
          (preferred to http://hl7.org/fhir/ValueSet/list-order)

          What order applies to the items in the entry.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

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

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

          ShortA reference to data that supports this section
          Comments

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

          Control0..*
          This element is affected by the following invariants: cmp-2
          TypeReference(List)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          330. Composition.section:medications.emptyReason
          Definition

          If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

          ShortWhy the section is empty
          Comments

          The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

          Control0..1
          This element is affected by the following invariants: cmp-2
          BindingThe codes SHOULD be taken from ListEmptyReasons
          (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

          If a section is empty, why it is empty.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Allows capturing things like "none exist" or "not asked" which can be important for most lists.

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

          A nested sub-section within this section.

          ShortNested Section
          Comments

          Nested sections are primarily used to help human readers navigate to particular portions of the document.

          Control0..*
          This element is affected by the following invariants: cmp-1
          TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          334. Composition.section:plan_of_care
          Slice Nameplan_of_care
          Definition

          The root of the sections that make up the composition.

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

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          338. Composition.section:plan_of_care.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

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

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          340. Composition.section:plan_of_care.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

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

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

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

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

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

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

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

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

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

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

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

          ShortClassification of section (recommended)
          Comments

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

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

          Control1..1
          BindingFor example codes, see DocumentSectionCodes
          (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

          Classification of a section of a composition/document.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Provides computable standardized labels to topics within the document.

          Pattern Value{
            "coding" : [{
              "system" : "http://loinc.org",
              "code" : "74449-0",
              "display" : "Patient plan of care - recommended IHE set"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          346. Composition.section:plan_of_care.author
          Definition

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

          ShortWho and/or what authored the section
          Control0..*
          TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
          Is Modifierfalse
          Summaryfalse
          Requirements

          Identifies who is responsible for the content.

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

          The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

          ShortWho/what the section is about, when it is not about the subject of composition
          Comments

          Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

          Control0..1
          TypeReference(Resource)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          350. Composition.section:plan_of_care.text
          Definition

          A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

          ShortText summary of the section, for human interpretation
          Comments

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

          Control1..1
          This element is affected by the following invariants: cmp-1
          TypeNarrative
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          352. Composition.section:plan_of_care.mode
          Definition

          How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

          Shortworking | snapshot | changes
          Comments

          This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

          Control0..1
          BindingThe codes SHALL be taken from ListMode
          (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

          The processing mode that applies to this section.

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

          Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

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

          Specifies the order applied to the items in the section entries.

          ShortOrder of section entries
          Comments

          Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

          Control0..1
          BindingThe codes SHOULD be taken from ListOrderCodes
          (preferred to http://hl7.org/fhir/ValueSet/list-order)

          What order applies to the items in the entry.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

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

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

          ShortA reference to data that supports this section
          Comments

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

          Control0..*
          This element is affected by the following invariants: cmp-2
          TypeReference(US Core CarePlan Profile)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          358. Composition.section:plan_of_care.emptyReason
          Definition

          If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

          ShortWhy the section is empty
          Comments

          The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

          Control0..1
          This element is affected by the following invariants: cmp-2
          BindingThe codes SHOULD be taken from ListEmptyReasons
          (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

          If a section is empty, why it is empty.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Allows capturing things like "none exist" or "not asked" which can be important for most lists.

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

          A nested sub-section within this section.

          ShortNested Section
          Comments

          Nested sections are primarily used to help human readers navigate to particular portions of the document.

          Control0..*
          This element is affected by the following invariants: cmp-1
          TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          362. Composition.section:problems
          Slice Nameproblems
          Definition

          The root of the sections that make up the composition.

          ShortProblem
          Control1..1
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          364. Composition.section:problems.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          366. Composition.section:problems.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

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

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          368. Composition.section:problems.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

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

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

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

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

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

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

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

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

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

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

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

          ShortClassification of section (recommended)
          Comments

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

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

          Control1..1
          BindingFor example codes, see DocumentSectionCodes
          (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

          Classification of a section of a composition/document.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Provides computable standardized labels to topics within the document.

          Pattern Value{
            "coding" : [{
              "system" : "http://loinc.org",
              "code" : "46019-6",
              "display" : "Diseases or conditions Set"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          374. Composition.section:problems.author
          Definition

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

          ShortWho and/or what authored the section
          Control0..*
          TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
          Is Modifierfalse
          Summaryfalse
          Requirements

          Identifies who is responsible for the content.

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

          The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

          ShortWho/what the section is about, when it is not about the subject of composition
          Comments

          Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

          Control0..1
          TypeReference(Resource)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          378. Composition.section:problems.text
          Definition

          A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

          ShortText summary of the section, for human interpretation
          Comments

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

          Control1..1
          This element is affected by the following invariants: cmp-1
          TypeNarrative
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          380. Composition.section:problems.mode
          Definition

          How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

          Shortworking | snapshot | changes
          Comments

          This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

          Control0..1
          BindingThe codes SHALL be taken from ListMode
          (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

          The processing mode that applies to this section.

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

          Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

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

          Specifies the order applied to the items in the section entries.

          ShortOrder of section entries
          Comments

          Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

          Control0..1
          BindingThe codes SHOULD be taken from ListOrderCodes
          (preferred to http://hl7.org/fhir/ValueSet/list-order)

          What order applies to the items in the entry.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

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

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

          ShortA reference to data that supports this section
          Comments

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

          Control0..*
          This element is affected by the following invariants: cmp-2
          TypeReference(US Core Condition Encounter Diagnosis Profile, US Core Condition Problems and Health Concerns Profile, US Core Simple Observation Profile)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          386. Composition.section:problems.emptyReason
          Definition

          If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

          ShortWhy the section is empty
          Comments

          The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

          Control0..1
          This element is affected by the following invariants: cmp-2
          BindingThe codes SHOULD be taken from ListEmptyReasons
          (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

          If a section is empty, why it is empty.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Allows capturing things like "none exist" or "not asked" which can be important for most lists.

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

          A nested sub-section within this section.

          ShortNested Section
          Comments

          Nested sections are primarily used to help human readers navigate to particular portions of the document.

          Control0..*
          This element is affected by the following invariants: cmp-1
          TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          390. Composition.section:procedures
          Slice Nameprocedures
          Definition

          The root of the sections that make up the composition.

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

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          394. Composition.section:procedures.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

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

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          396. Composition.section:procedures.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

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

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

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

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

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

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

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

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

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

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

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

          ShortClassification of section (recommended)
          Comments

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

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

          Control1..1
          BindingFor example codes, see DocumentSectionCodes
          (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

          Classification of a section of a composition/document.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Provides computable standardized labels to topics within the document.

          Pattern Value{
            "coding" : [{
              "system" : "http://loinc.org",
              "code" : "28570-0",
              "display" : "Procedure note"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          402. Composition.section:procedures.author
          Definition

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

          ShortWho and/or what authored the section
          Control0..*
          TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
          Is Modifierfalse
          Summaryfalse
          Requirements

          Identifies who is responsible for the content.

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

          The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

          ShortWho/what the section is about, when it is not about the subject of composition
          Comments

          Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

          Control0..1
          TypeReference(Resource)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          406. Composition.section:procedures.text
          Definition

          A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

          ShortText summary of the section, for human interpretation
          Comments

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

          Control1..1
          This element is affected by the following invariants: cmp-1
          TypeNarrative
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          408. Composition.section:procedures.mode
          Definition

          How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

          Shortworking | snapshot | changes
          Comments

          This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

          Control0..1
          BindingThe codes SHALL be taken from ListMode
          (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

          The processing mode that applies to this section.

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

          Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

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

          Specifies the order applied to the items in the section entries.

          ShortOrder of section entries
          Comments

          Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

          Control0..1
          BindingThe codes SHOULD be taken from ListOrderCodes
          (preferred to http://hl7.org/fhir/ValueSet/list-order)

          What order applies to the items in the entry.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

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

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

          ShortA reference to data that supports this section
          Comments

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

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

          If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

          ShortWhy the section is empty
          Comments

          The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

          Control0..1
          This element is affected by the following invariants: cmp-2
          BindingThe codes SHOULD be taken from ListEmptyReasons
          (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

          If a section is empty, why it is empty.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Allows capturing things like "none exist" or "not asked" which can be important for most lists.

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

          A nested sub-section within this section.

          ShortNested Section
          Comments

          Nested sections are primarily used to help human readers navigate to particular portions of the document.

          Control0..*
          This element is affected by the following invariants: cmp-1
          TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          418. Composition.section:reason_for_referral
          Slice Namereason_for_referral
          Definition

          The root of the sections that make up the composition.

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

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          422. Composition.section:reason_for_referral.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

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

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          424. Composition.section:reason_for_referral.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

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

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          426. Composition.section:reason_for_referral.title
          Definition

          The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

          ShortLabel for section (e.g. for ToC)
          Comments

          The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

          Control1..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summaryfalse
          Requirements

          Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

          Alternate Namesheader, label, caption
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          428. Composition.section:reason_for_referral.code
          Definition

          A code identifying the kind of content contained within the section. This must be consistent with the section title.

          ShortClassification of section (recommended)
          Comments

          The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

          If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

          Control1..1
          BindingFor example codes, see DocumentSectionCodes
          (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

          Classification of a section of a composition/document.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Provides computable standardized labels to topics within the document.

          Pattern Value{
            "coding" : [{
              "system" : "http://loinc.org",
              "code" : "42349-1",
              "display" : "Reason for referral (narrative)"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          430. Composition.section:reason_for_referral.author
          Definition

          Identifies who is responsible for the information in this section, not necessarily who typed it in.

          ShortWho and/or what authored the section
          Control0..*
          TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
          Is Modifierfalse
          Summaryfalse
          Requirements

          Identifies who is responsible for the content.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          432. Composition.section:reason_for_referral.focus
          Definition

          The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

          ShortWho/what the section is about, when it is not about the subject of composition
          Comments

          Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

          Control0..1
          TypeReference(Resource)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          434. Composition.section:reason_for_referral.text
          Definition

          A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

          ShortText summary of the section, for human interpretation
          Comments

          Document profiles may define what content should be represented in the narrative to ensure clinical safety.

          Control1..1
          This element is affected by the following invariants: cmp-1
          TypeNarrative
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          436. Composition.section:reason_for_referral.mode
          Definition

          How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

          Shortworking | snapshot | changes
          Comments

          This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

          Control0..1
          BindingThe codes SHALL be taken from ListMode
          (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

          The processing mode that applies to this section.

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Requirements

          Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          438. Composition.section:reason_for_referral.orderedBy
          Definition

          Specifies the order applied to the items in the section entries.

          ShortOrder of section entries
          Comments

          Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

          Control0..1
          BindingThe codes SHOULD be taken from ListOrderCodes
          (preferred to http://hl7.org/fhir/ValueSet/list-order)

          What order applies to the items in the entry.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          440. Composition.section:reason_for_referral.entry
          Definition

          A reference to the actual resource from which the narrative in the section is derived.

          ShortA reference to data that supports this section
          Comments

          If there are no entries in the list, an emptyReason SHOULD be provided.

          Control0..*
          This element is affected by the following invariants: cmp-2
          TypeReference(US Core Condition Problems and Health Concerns Profile, US Core Condition Encounter Diagnosis Profile, US Core Procedure Profile, Observation, ImmunizationRecommendation, Discharge Summary, US Core Encounter Profile)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          442. Composition.section:reason_for_referral.emptyReason
          Definition

          If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

          ShortWhy the section is empty
          Comments

          The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

          Control0..1
          This element is affected by the following invariants: cmp-2
          BindingThe codes SHOULD be taken from ListEmptyReasons
          (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

          If a section is empty, why it is empty.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Allows capturing things like "none exist" or "not asked" which can be important for most lists.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          444. Composition.section:reason_for_referral.section
          Definition

          A nested sub-section within this section.

          ShortNested Section
          Comments

          Nested sections are primarily used to help human readers navigate to particular portions of the document.

          Control0..*
          This element is affected by the following invariants: cmp-1
          TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          446. Composition.section:reason_for_visit
          Slice Namereason_for_visit
          Definition

          The root of the sections that make up the composition.

          ShortReason for Visit (Ambulatory)
          Control0..1
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          448. Composition.section:reason_for_visit.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          450. Composition.section:reason_for_visit.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          452. Composition.section:reason_for_visit.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          454. Composition.section:reason_for_visit.title
          Definition

          The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

          ShortLabel for section (e.g. for ToC)
          Comments

          The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

          Control1..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summaryfalse
          Requirements

          Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

          Alternate Namesheader, label, caption
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          456. Composition.section:reason_for_visit.code
          Definition

          A code identifying the kind of content contained within the section. This must be consistent with the section title.

          ShortClassification of section (recommended)
          Comments

          The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

          If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

          Control1..1
          BindingFor example codes, see DocumentSectionCodes
          (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

          Classification of a section of a composition/document.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Provides computable standardized labels to topics within the document.

          Pattern Value{
            "coding" : [{
              "system" : "http://loinc.org",
              "code" : "29299-5",
              "display" : "Reason for visit Narrative"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          458. Composition.section:reason_for_visit.author
          Definition

          Identifies who is responsible for the information in this section, not necessarily who typed it in.

          ShortWho and/or what authored the section
          Control0..*
          TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
          Is Modifierfalse
          Summaryfalse
          Requirements

          Identifies who is responsible for the content.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          460. Composition.section:reason_for_visit.focus
          Definition

          The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

          ShortWho/what the section is about, when it is not about the subject of composition
          Comments

          Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

          Control0..1
          TypeReference(Resource)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          462. Composition.section:reason_for_visit.text
          Definition

          A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

          ShortText summary of the section, for human interpretation
          Comments

          Document profiles may define what content should be represented in the narrative to ensure clinical safety.

          Control1..1
          This element is affected by the following invariants: cmp-1
          TypeNarrative
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          464. Composition.section:reason_for_visit.mode
          Definition

          How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

          Shortworking | snapshot | changes
          Comments

          This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

          Control0..1
          BindingThe codes SHALL be taken from ListMode
          (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

          The processing mode that applies to this section.

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Requirements

          Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          466. Composition.section:reason_for_visit.orderedBy
          Definition

          Specifies the order applied to the items in the section entries.

          ShortOrder of section entries
          Comments

          Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

          Control0..1
          BindingThe codes SHOULD be taken from ListOrderCodes
          (preferred to http://hl7.org/fhir/ValueSet/list-order)

          What order applies to the items in the entry.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          468. Composition.section:reason_for_visit.entry
          Definition

          A reference to the actual resource from which the narrative in the section is derived.

          ShortA reference to data that supports this section
          Comments

          If there are no entries in the list, an emptyReason SHOULD be provided.

          Control0..*
          This element is affected by the following invariants: cmp-2
          TypeReference(US Core Condition Problems and Health Concerns Profile, US Core Condition Encounter Diagnosis Profile, US Core Procedure Profile, Observation, ImmunizationRecommendation, Discharge Summary, US Core Encounter Profile)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          470. Composition.section:reason_for_visit.emptyReason
          Definition

          If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

          ShortWhy the section is empty
          Comments

          The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

          Control0..1
          This element is affected by the following invariants: cmp-2
          BindingThe codes SHOULD be taken from ListEmptyReasons
          (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

          If a section is empty, why it is empty.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Allows capturing things like "none exist" or "not asked" which can be important for most lists.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          472. Composition.section:reason_for_visit.section
          Definition

          A nested sub-section within this section.

          ShortNested Section
          Comments

          Nested sections are primarily used to help human readers navigate to particular portions of the document.

          Control0..*
          This element is affected by the following invariants: cmp-1
          TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          474. Composition.section:results
          Slice Nameresults
          Definition

          The root of the sections that make up the composition.

          ShortRecent Test Results
          Control1..1
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          476. Composition.section:results.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          478. Composition.section:results.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          480. Composition.section:results.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          482. Composition.section:results.title
          Definition

          The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

          ShortLabel for section (e.g. for ToC)
          Comments

          The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

          Control1..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summaryfalse
          Requirements

          Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

          Alternate Namesheader, label, caption
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          484. Composition.section:results.code
          Definition

          A code identifying the kind of content contained within the section. This must be consistent with the section title.

          ShortClassification of section (recommended)
          Comments

          The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

          If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

          Control1..1
          BindingFor example codes, see DocumentSectionCodes
          (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

          Classification of a section of a composition/document.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Provides computable standardized labels to topics within the document.

          Pattern Value{
            "coding" : [{
              "system" : "http://loinc.org",
              "code" : "19146-0",
              "display" : "Referral lab test results"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          486. Composition.section:results.author
          Definition

          Identifies who is responsible for the information in this section, not necessarily who typed it in.

          ShortWho and/or what authored the section
          Control0..*
          TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
          Is Modifierfalse
          Summaryfalse
          Requirements

          Identifies who is responsible for the content.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          488. Composition.section:results.focus
          Definition

          The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

          ShortWho/what the section is about, when it is not about the subject of composition
          Comments

          Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

          Control0..1
          TypeReference(Resource)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          490. Composition.section:results.text
          Definition

          A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

          ShortText summary of the section, for human interpretation
          Comments

          Document profiles may define what content should be represented in the narrative to ensure clinical safety.

          Control1..1
          This element is affected by the following invariants: cmp-1
          TypeNarrative
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          492. Composition.section:results.mode
          Definition

          How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

          Shortworking | snapshot | changes
          Comments

          This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

          Control0..1
          BindingThe codes SHALL be taken from ListMode
          (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

          The processing mode that applies to this section.

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Requirements

          Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          494. Composition.section:results.orderedBy
          Definition

          Specifies the order applied to the items in the section entries.

          ShortOrder of section entries
          Comments

          Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

          Control0..1
          BindingThe codes SHOULD be taken from ListOrderCodes
          (preferred to http://hl7.org/fhir/ValueSet/list-order)

          What order applies to the items in the entry.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          496. Composition.section:results.entry
          Definition

          A reference to the actual resource from which the narrative in the section is derived.

          ShortA reference to data that supports this section
          Comments

          If there are no entries in the list, an emptyReason SHOULD be provided.

          Control0..*
          This element is affected by the following invariants: cmp-2
          TypeReference(US Core Observation Clinical Result Profile)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          498. Composition.section:results.emptyReason
          Definition

          If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

          ShortWhy the section is empty
          Comments

          The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

          Control0..1
          This element is affected by the following invariants: cmp-2
          BindingThe codes SHOULD be taken from ListEmptyReasons
          (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

          If a section is empty, why it is empty.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Allows capturing things like "none exist" or "not asked" which can be important for most lists.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          500. Composition.section:results.section
          Definition

          A nested sub-section within this section.

          ShortNested Section
          Comments

          Nested sections are primarily used to help human readers navigate to particular portions of the document.

          Control0..*
          This element is affected by the following invariants: cmp-1
          TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          502. Composition.section:social_history
          Slice Namesocial_history
          Definition

          The root of the sections that make up the composition.

          ShortSocial History
          Control0..1
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          504. Composition.section:social_history.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          506. Composition.section:social_history.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          508. Composition.section:social_history.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          510. Composition.section:social_history.title
          Definition

          The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

          ShortLabel for section (e.g. for ToC)
          Comments

          The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

          Control1..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summaryfalse
          Requirements

          Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

          Alternate Namesheader, label, caption
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          512. Composition.section:social_history.code
          Definition

          A code identifying the kind of content contained within the section. This must be consistent with the section title.

          ShortClassification of section (recommended)
          Comments

          The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

          If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

          Control1..1
          BindingFor example codes, see DocumentSectionCodes
          (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

          Classification of a section of a composition/document.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Provides computable standardized labels to topics within the document.

          Pattern Value{
            "coding" : [{
              "system" : "http://loinc.org",
              "code" : "10166-7",
              "display" : "History of Social function Narrative"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          514. Composition.section:social_history.author
          Definition

          Identifies who is responsible for the information in this section, not necessarily who typed it in.

          ShortWho and/or what authored the section
          Control0..*
          TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
          Is Modifierfalse
          Summaryfalse
          Requirements

          Identifies who is responsible for the content.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          516. Composition.section:social_history.focus
          Definition

          The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

          ShortWho/what the section is about, when it is not about the subject of composition
          Comments

          Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

          Control0..1
          TypeReference(Resource)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          518. Composition.section:social_history.text
          Definition

          A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

          ShortText summary of the section, for human interpretation
          Comments

          Document profiles may define what content should be represented in the narrative to ensure clinical safety.

          Control1..1
          This element is affected by the following invariants: cmp-1
          TypeNarrative
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          520. Composition.section:social_history.mode
          Definition

          How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

          Shortworking | snapshot | changes
          Comments

          This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

          Control0..1
          BindingThe codes SHALL be taken from ListMode
          (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

          The processing mode that applies to this section.

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Requirements

          Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          522. Composition.section:social_history.orderedBy
          Definition

          Specifies the order applied to the items in the section entries.

          ShortOrder of section entries
          Comments

          Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

          Control0..1
          BindingThe codes SHOULD be taken from ListOrderCodes
          (preferred to http://hl7.org/fhir/ValueSet/list-order)

          What order applies to the items in the entry.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          524. Composition.section:social_history.entry
          Definition

          A reference to the actual resource from which the narrative in the section is derived.

          ShortA reference to data that supports this section
          Comments

          If there are no entries in the list, an emptyReason SHOULD be provided.

          Control0..*
          This element is affected by the following invariants: cmp-2
          TypeReference(US Core Simple Observation Profile, US Core Smoking Status Observation Profile, Composition (IPS), Personal Functioning and Engagement Narrative History of Status, US Core CarePlan Profile, US Core Patient Profile, US Core Coverage Profile, Dental Bundle)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          526. Composition.section:social_history.emptyReason
          Definition

          If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

          ShortWhy the section is empty
          Comments

          The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

          Control0..1
          This element is affected by the following invariants: cmp-2
          BindingThe codes SHOULD be taken from ListEmptyReasons
          (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

          If a section is empty, why it is empty.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Allows capturing things like "none exist" or "not asked" which can be important for most lists.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          528. Composition.section:social_history.section
          Definition

          A nested sub-section within this section.

          ShortNested Section
          Comments

          Nested sections are primarily used to help human readers navigate to particular portions of the document.

          Control0..*
          This element is affected by the following invariants: cmp-1
          TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          530. Composition.section:vital_signs
          Slice Namevital_signs
          Definition

          The root of the sections that make up the composition.

          ShortVital Signs
          Control0..1
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          532. Composition.section:vital_signs.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          534. Composition.section:vital_signs.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          536. Composition.section:vital_signs.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          538. Composition.section:vital_signs.title
          Definition

          The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

          ShortLabel for section (e.g. for ToC)
          Comments

          The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

          Control1..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summaryfalse
          Requirements

          Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

          Alternate Namesheader, label, caption
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          540. Composition.section:vital_signs.code
          Definition

          A code identifying the kind of content contained within the section. This must be consistent with the section title.

          ShortClassification of section (recommended)
          Comments

          The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

          If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

          Control1..1
          BindingFor example codes, see DocumentSectionCodes
          (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

          Classification of a section of a composition/document.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Provides computable standardized labels to topics within the document.

          Pattern Value{
            "coding" : [{
              "system" : "http://loinc.org",
              "code" : "LP30605-7",
              "display" : "Vital signs"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          542. Composition.section:vital_signs.author
          Definition

          Identifies who is responsible for the information in this section, not necessarily who typed it in.

          ShortWho and/or what authored the section
          Control0..*
          TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
          Is Modifierfalse
          Summaryfalse
          Requirements

          Identifies who is responsible for the content.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          544. Composition.section:vital_signs.focus
          Definition

          The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

          ShortWho/what the section is about, when it is not about the subject of composition
          Comments

          Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

          Control0..1
          TypeReference(Resource)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          546. Composition.section:vital_signs.text
          Definition

          A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

          ShortText summary of the section, for human interpretation
          Comments

          Document profiles may define what content should be represented in the narrative to ensure clinical safety.

          Control1..1
          This element is affected by the following invariants: cmp-1
          TypeNarrative
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          548. Composition.section:vital_signs.mode
          Definition

          How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

          Shortworking | snapshot | changes
          Comments

          This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

          Control0..1
          BindingThe codes SHALL be taken from ListMode
          (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

          The processing mode that applies to this section.

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Requirements

          Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          550. Composition.section:vital_signs.orderedBy
          Definition

          Specifies the order applied to the items in the section entries.

          ShortOrder of section entries
          Comments

          Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

          Control0..1
          BindingThe codes SHOULD be taken from ListOrderCodes
          (preferred to http://hl7.org/fhir/ValueSet/list-order)

          What order applies to the items in the entry.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          552. Composition.section:vital_signs.entry
          Definition

          A reference to the actual resource from which the narrative in the section is derived.

          ShortA reference to data that supports this section
          Comments

          If there are no entries in the list, an emptyReason SHOULD be provided.

          Control0..*
          This element is affected by the following invariants: cmp-2
          TypeReference(US Core Vital Signs Profile)
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          554. Composition.section:vital_signs.emptyReason
          Definition

          If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

          ShortWhy the section is empty
          Comments

          The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

          Control0..1
          This element is affected by the following invariants: cmp-2
          BindingThe codes SHOULD be taken from ListEmptyReasons
          (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

          If a section is empty, why it is empty.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Allows capturing things like "none exist" or "not asked" which can be important for most lists.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          556. Composition.section:vital_signs.section
          Definition

          A nested sub-section within this section.

          ShortNested Section
          Comments

          Nested sections are primarily used to help human readers navigate to particular portions of the document.

          Control0..*
          This element is affected by the following invariants: cmp-1
          TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))