PACIO Transitions of Care Implementation Guide
1.0.0 - STU 1 US

PACIO Transitions of Care Implementation Guide - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## Resource Profile: Transition of Care Composition

Official URL: http://hl7.org/fhir/us/pacio-toc/StructureDefinition/TOC-Composition | Version: 1.0.0
Standards status: Trial-use | Maturity Level: 2 | Computable Name: TOCComposition

This profile defines constraints that represent common administrative and demographic concepts for transitions of care information used in US Realm clinical documents.

Representation Guidance

- Assumes that all of the Composition sections were assembled for sending at same time, identified by the `Composition.date element` because there may be too much variability in where and how each section's artifacts are timestamped.

Usages:

- Use this Profile: Transition of Care Bundle
- Examples for this Profile: Composition/BSJ-TOCComposition
- CapabilityStatements using this Profile: TOC CapabilityStatement

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Composition.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Composition.status | Base | required | CompositionStatus | 📍4.0.1 | FHIR Std.
Composition.type | Base | extensible | FHIR Document Type Codes | 📦4.0.1 | FHIR Std.
Composition.category | Base | example | Document Class Value Set | 📍4.0.1 | FHIR Std.
Composition.section:advance_directives.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:advance_directives.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:allergies.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:allergies.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:behavioral_health.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:behavioral_health.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:functional_status.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:functional_status.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:immunizations.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:immunizations.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:discharge_instructions.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:discharge_instructions.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:medical_devices.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:medical_devices.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:medications.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:medications.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:plan_of_care.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:plan_of_care.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:problems.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:problems.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:procedures.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:reason_for_referral.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:reason_for_referral.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:clinical_results.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:clinical_results.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:social_history.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:social_history.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:vital_signs.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:vital_signs.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
cmp-1 | error | Composition.section, Composition.section:advance_directives, Composition.section:allergies, Composition.section:behavioral_health, Composition.section:functional_status, Composition.section:immunizations, Composition.section:discharge_instructions, Composition.section:medical_devices, Composition.section:medications, Composition.section:plan_of_care, Composition.section:problems, Composition.section:procedures, Composition.section:reason_for_referral, Composition.section:clinical_results, Composition.section:social_history, Composition.section:vital_signs | A section must contain at least one of text, entries, or sub-sections | `text.exists() or entry.exists() or section.exists()`
cmp-2 | error | Composition.section, Composition.section:advance_directives, Composition.section:allergies, Composition.section:behavioral_health, Composition.section:functional_status, Composition.section:immunizations, Composition.section:discharge_instructions, Composition.section:medical_devices, Composition.section:medications, Composition.section:plan_of_care, Composition.section:problems, Composition.section:procedures, Composition.section:reason_for_referral, Composition.section:clinical_results, Composition.section:social_history, Composition.section:vital_signs | A section can only have an emptyReason if it is empty | `emptyReason.empty() or entry.empty()`
dom-2 | error | Composition | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Composition | 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 | error | Composition | 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 | error | Composition | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Composition | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from Clinical Document

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Composition.type | Base | extensible | FHIR Document Type Codes | 📦4.0.1 | FHIR Std.

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Composition.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Composition.status | Base | required | CompositionStatus | 📍4.0.1 | FHIR Std.
Composition.type | Base | extensible | FHIR Document Type Codes | 📦4.0.1 | FHIR Std.
Composition.category | Base | example | Document Class Value Set | 📍4.0.1 | FHIR Std.
Composition.attester.​mode | Base | required | CompositionAttestationMode | 📍4.0.1 | FHIR Std.
Composition.relatesTo.​code | Base | required | DocumentRelationshipType | 📍4.0.1 | FHIR Std.
Composition.event.code | Base | example | v3 Code System ActCode | 📍3.0.0 | THO v7.1
Composition.section.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:advance_directives.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:advance_directives.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:advance_directives.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:advance_directives.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:allergies.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:allergies.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:allergies.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:allergies.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:behavioral_health.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:behavioral_health.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:behavioral_health.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:behavioral_health.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:functional_status.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:functional_status.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:functional_status.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:functional_status.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:immunizations.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:immunizations.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:immunizations.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:immunizations.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:discharge_instructions.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:discharge_instructions.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:discharge_instructions.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:discharge_instructions.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:medical_devices.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:medical_devices.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:medical_devices.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:medical_devices.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:medications.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:medications.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:medications.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:medications.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:plan_of_care.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:plan_of_care.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:plan_of_care.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:plan_of_care.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:problems.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:problems.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:problems.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:problems.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:procedures.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:procedures.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:procedures.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:procedures.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:reason_for_referral.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:reason_for_referral.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:reason_for_referral.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:reason_for_referral.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:clinical_results.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:clinical_results.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:clinical_results.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:clinical_results.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:social_history.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:social_history.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:social_history.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:social_history.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:vital_signs.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:vital_signs.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:vital_signs.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:vital_signs.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
cmp-1 | error | Composition.section, Composition.section:advance_directives, Composition.section:allergies, Composition.section:behavioral_health, Composition.section:functional_status, Composition.section:immunizations, Composition.section:discharge_instructions, Composition.section:medical_devices, Composition.section:medications, Composition.section:plan_of_care, Composition.section:problems, Composition.section:procedures, Composition.section:reason_for_referral, Composition.section:clinical_results, Composition.section:social_history, Composition.section:vital_signs | A section must contain at least one of text, entries, or sub-sections | `text.exists() or entry.exists() or section.exists()`
cmp-2 | error | Composition.section, Composition.section:advance_directives, Composition.section:allergies, Composition.section:behavioral_health, Composition.section:functional_status, Composition.section:immunizations, Composition.section:discharge_instructions, Composition.section:medical_devices, Composition.section:medications, Composition.section:plan_of_care, Composition.section:problems, Composition.section:procedures, Composition.section:reason_for_referral, Composition.section:clinical_results, Composition.section:social_history, Composition.section:vital_signs | A section can only have an emptyReason if it is empty | `emptyReason.empty() or entry.empty()`
dom-2 | error | Composition | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Composition | 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 | error | Composition | 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 | error | Composition | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Composition | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from Clinical Document

Summary

Mandatory: 50 elements
Must-Support: 54 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

- US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient|8.0.1)
- US Core Encounter Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter|8.0.1)
- US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner|8.0.1)
- US Core PractitionerRole Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole|8.0.1)
- US Core Organization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization|8.0.1)
- ADI Document Reference (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-DocumentReference)
- US Core AllergyIntolerance Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance|8.0.1)
- US Core Condition Problems and Health Concerns Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-problems-health-concerns|8.0.1)
- US Core Simple Observation Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-simple-observation|8.0.1)
- Personal Functioning and Engagement Use of Device (http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-use-of-device)
- Personal Functioning and Engagement Narrative History of Status (http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-narrative-history-of-status)
- US Core Immunization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization|8.0.1)
- US Core DiagnosticReport Profile for Report and Note Exchange (http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note|8.0.1)
- US Core DocumentReference Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference|8.0.1)
- Standardized Medication Profile - Medication List (http://hl7.org/fhir/us/smp/StructureDefinition/smp-medication-list)
- US Core MedicationRequest Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest|8.0.1)
- US Core Medication Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication|8.0.1)
- US Core CarePlan Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-careplan|8.0.1)
- US Core Condition Encounter Diagnosis Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-encounter-diagnosis|8.0.1)
- US Core Procedure Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure|8.0.1)
- Discharge Summary (http://hl7.org/fhir/us/ccda/StructureDefinition/Discharge-Summary|1.2.0)
- US Core Observation Clinical Result Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-clinical-result|8.0.1)
- US Core Smoking Status Observation Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus|8.0.1)
- US Core Vital Signs Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-vital-signs|8.0.1)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Composition.section

Maturity: 2

Key Elements View

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Composition.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Composition.status | Base | required | CompositionStatus | 📍4.0.1 | FHIR Std.
Composition.type | Base | extensible | FHIR Document Type Codes | 📦4.0.1 | FHIR Std.
Composition.category | Base | example | Document Class Value Set | 📍4.0.1 | FHIR Std.
Composition.section:advance_directives.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:advance_directives.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:allergies.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:allergies.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:behavioral_health.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:behavioral_health.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:functional_status.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:functional_status.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:immunizations.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:immunizations.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:discharge_instructions.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:discharge_instructions.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:medical_devices.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:medical_devices.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:medications.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:medications.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:plan_of_care.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:plan_of_care.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:problems.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:problems.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:procedures.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:reason_for_referral.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:reason_for_referral.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:clinical_results.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:clinical_results.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:social_history.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:social_history.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:vital_signs.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:vital_signs.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
cmp-1 | error | Composition.section, Composition.section:advance_directives, Composition.section:allergies, Composition.section:behavioral_health, Composition.section:functional_status, Composition.section:immunizations, Composition.section:discharge_instructions, Composition.section:medical_devices, Composition.section:medications, Composition.section:plan_of_care, Composition.section:problems, Composition.section:procedures, Composition.section:reason_for_referral, Composition.section:clinical_results, Composition.section:social_history, Composition.section:vital_signs | A section must contain at least one of text, entries, or sub-sections | `text.exists() or entry.exists() or section.exists()`
cmp-2 | error | Composition.section, Composition.section:advance_directives, Composition.section:allergies, Composition.section:behavioral_health, Composition.section:functional_status, Composition.section:immunizations, Composition.section:discharge_instructions, Composition.section:medical_devices, Composition.section:medications, Composition.section:plan_of_care, Composition.section:problems, Composition.section:procedures, Composition.section:reason_for_referral, Composition.section:clinical_results, Composition.section:social_history, Composition.section:vital_signs | A section can only have an emptyReason if it is empty | `emptyReason.empty() or entry.empty()`
dom-2 | error | Composition | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Composition | 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 | error | Composition | 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 | error | Composition | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Composition | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Differential View

This structure is derived from Clinical Document

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Composition.type | Base | extensible | FHIR Document Type Codes | 📦4.0.1 | FHIR Std.

Snapshot View

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Composition.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Composition.status | Base | required | CompositionStatus | 📍4.0.1 | FHIR Std.
Composition.type | Base | extensible | FHIR Document Type Codes | 📦4.0.1 | FHIR Std.
Composition.category | Base | example | Document Class Value Set | 📍4.0.1 | FHIR Std.
Composition.attester.​mode | Base | required | CompositionAttestationMode | 📍4.0.1 | FHIR Std.
Composition.relatesTo.​code | Base | required | DocumentRelationshipType | 📍4.0.1 | FHIR Std.
Composition.event.code | Base | example | v3 Code System ActCode | 📍3.0.0 | THO v7.1
Composition.section.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:advance_directives.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:advance_directives.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:advance_directives.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:advance_directives.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:allergies.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:allergies.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:allergies.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:allergies.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:behavioral_health.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:behavioral_health.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:behavioral_health.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:behavioral_health.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:functional_status.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:functional_status.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:functional_status.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:functional_status.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:immunizations.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:immunizations.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:immunizations.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:immunizations.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:discharge_instructions.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:discharge_instructions.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:discharge_instructions.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:discharge_instructions.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:medical_devices.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:medical_devices.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:medical_devices.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:medical_devices.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:medications.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:medications.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:medications.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:medications.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:plan_of_care.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:plan_of_care.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:plan_of_care.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:plan_of_care.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:problems.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:problems.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:problems.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:problems.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:procedures.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:procedures.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:procedures.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:procedures.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:reason_for_referral.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:reason_for_referral.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:reason_for_referral.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:reason_for_referral.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:clinical_results.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:clinical_results.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:clinical_results.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:clinical_results.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:social_history.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:social_history.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:social_history.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:social_history.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:vital_signs.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:vital_signs.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:vital_signs.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:vital_signs.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
cmp-1 | error | Composition.section, Composition.section:advance_directives, Composition.section:allergies, Composition.section:behavioral_health, Composition.section:functional_status, Composition.section:immunizations, Composition.section:discharge_instructions, Composition.section:medical_devices, Composition.section:medications, Composition.section:plan_of_care, Composition.section:problems, Composition.section:procedures, Composition.section:reason_for_referral, Composition.section:clinical_results, Composition.section:social_history, Composition.section:vital_signs | A section must contain at least one of text, entries, or sub-sections | `text.exists() or entry.exists() or section.exists()`
cmp-2 | error | Composition.section, Composition.section:advance_directives, Composition.section:allergies, Composition.section:behavioral_health, Composition.section:functional_status, Composition.section:immunizations, Composition.section:discharge_instructions, Composition.section:medical_devices, Composition.section:medications, Composition.section:plan_of_care, Composition.section:problems, Composition.section:procedures, Composition.section:reason_for_referral, Composition.section:clinical_results, Composition.section:social_history, Composition.section:vital_signs | A section can only have an emptyReason if it is empty | `emptyReason.empty() or entry.empty()`
dom-2 | error | Composition | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Composition | 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 | error | Composition | 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 | error | Composition | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Composition | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from Clinical Document

Summary

Mandatory: 50 elements
Must-Support: 54 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

- US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient|8.0.1)
- US Core Encounter Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter|8.0.1)
- US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner|8.0.1)
- US Core PractitionerRole Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole|8.0.1)
- US Core Organization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization|8.0.1)
- ADI Document Reference (http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-DocumentReference)
- US Core AllergyIntolerance Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance|8.0.1)
- US Core Condition Problems and Health Concerns Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-problems-health-concerns|8.0.1)
- US Core Simple Observation Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-simple-observation|8.0.1)
- Personal Functioning and Engagement Use of Device (http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-use-of-device)
- Personal Functioning and Engagement Narrative History of Status (http://hl7.org/fhir/us/pacio-pfe/StructureDefinition/pfe-narrative-history-of-status)
- US Core Immunization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-immunization|8.0.1)
- US Core DiagnosticReport Profile for Report and Note Exchange (http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note|8.0.1)
- US Core DocumentReference Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference|8.0.1)
- Standardized Medication Profile - Medication List (http://hl7.org/fhir/us/smp/StructureDefinition/smp-medication-list)
- US Core MedicationRequest Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest|8.0.1)
- US Core Medication Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication|8.0.1)
- US Core CarePlan Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-careplan|8.0.1)
- US Core Condition Encounter Diagnosis Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-encounter-diagnosis|8.0.1)
- US Core Procedure Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure|8.0.1)
- Discharge Summary (http://hl7.org/fhir/us/ccda/StructureDefinition/Discharge-Summary|1.2.0)
- US Core Observation Clinical Result Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-clinical-result|8.0.1)
- US Core Smoking Status Observation Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus|8.0.1)
- US Core Vital Signs Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-vital-signs|8.0.1)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Composition.section

Maturity: 2

Other representations of profile: CSV, Excel, Schematron