QI-Core Implementation Guide: STU 3.2 (v3.2.0 for FHIR 3.0.1)

This page is part of the Quality Improvement Core Framework (v3.2.0: STU 3) based on FHIR R3. The current version which supercedes this version is 4.1.1. For a full list of available versions, see the Directory of published versions

QICore-Specimen

Formats: Narrative, XML, JSON, Turtle

Raw json

{
  "resourceType" : "StructureDefinition",
  "id" : "qicore-specimen",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><th style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/STU3/formats.html#table\" title=\"The logical name of the element\">Name</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/STU3/formats.html#table\" title=\"Information about the use of the element\">Flags</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/STU3/formats.html#table\" title=\"Minimum and Maximum # of times the the element can appear in the instance\">Card.</a></th><th style=\"width: 100px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/STU3/formats.html#table\" title=\"Reference to the type of the element\">Type</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/STU3/formats.html#table\" title=\"Additional information about the element\">Description &amp; Constraints</a><span style=\"float: right\"><a href=\"http://hl7.org/fhir/STU3/formats.html#table\" title=\"Legend for this format\"><img src=\"http://hl7.org/fhir/STU3/help16.png\" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-qicore-specimen-definitions.html#Specimen\">Specimen</a><a name=\"Specimen\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-qicore-specimen-definitions.html#Specimen.container\">container</a><a name=\"Specimen.container\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck104.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_extension_simple.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Simple Extension\" class=\"hierarchy\"/> <a href=\"StructureDefinition-qicore-specimen-definitions.html#Specimen.container.extension:container-sequenceNumber\" title=\"Extension URL = http://hl7.org/fhir/StructureDefinition/specimen-sequenceNumber\">specimen-sequenceNumber</a><a name=\"Specimen.container.extension\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/STU3/datatypes.html#integer\">integer</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">The sequence number of the sample<br/><span style=\"font-weight:bold\">URL: </span><a href=\"http://hl7.org/fhir/STU3/extension-specimen-sequencenumber.html\">http://hl7.org/fhir/StructureDefinition/specimen-sequenceNumber</a></td></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-qicore-specimen-definitions.html#Specimen.collection\">collection</a><a name=\"Specimen.collection\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-qicore-specimen-definitions.html#Specimen.processing\">processing</a><a name=\"Specimen.processing\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-qicore-specimen-definitions.html#Specimen.type\">type</a><a name=\"Specimen.type\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_reference.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Reference to another Resource\" class=\"hierarchy\"/> <a href=\"StructureDefinition-qicore-specimen-definitions.html#Specimen.parent\">parent</a><a name=\"Specimen.parent\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/STU3/references.html\">Reference</a>(http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-specimen)</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_reference.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Reference to another Resource\" class=\"hierarchy\"/> <a href=\"StructureDefinition-qicore-specimen-definitions.html#Specimen.subject\">subject</a><a name=\"Specimen.subject\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/STU3/references.html\">Reference</a>(<a href=\"StructureDefinition-qicore-patient.html\">QICore-Patient</a> | <a href=\"StructureDefinition-qicore-device.html\">QICore-Device</a> | http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-substance | <a href=\"http://hl7.org/fhir/STU3/group.html\">Group</a>)</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white;\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_element.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Element\" class=\"hierarchy\"/> <a href=\"StructureDefinition-qicore-specimen-definitions.html#Specimen.receivedTime\">receivedTime</a><a name=\"Specimen.receivedTime\"> </a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span style=\"padding-left: 3px; padding-right: 3px; color: white; background-color: red\" title=\"This element must be supported\">S</span></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr><td colspan=\"5\" class=\"hierarchy\"><br/><a href=\"http://hl7.org/fhir/STU3/formats.html#table\" title=\"Legend for this format\"><img src=\"http://hl7.org/fhir/STU3/help16.png\" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table></div>"
  },
  "url" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-specimen",
  "version" : "3.2.0",
  "name" : "QICore-Specimen",
  "status" : "draft",
  "experimental" : false,
  "date" : "2018-08-22T00:00:00+10:00",
  "publisher" : "Health Level Seven, Inc. - CQI WG",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://hl7.org/special/committees/CQI"
        }
      ]
    }
  ],
  "description" : "Profile of Specimen for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "us"
        }
      ]
    }
  ],
  "fhirVersion" : "3.0.1",
  "mapping" : [
    {
      "identity" : "qidam",
      "uri" : "http://www.hl7.org/implement/standards/product_brief.cfm?product_id=378",
      "name" : "Quality Improvement Domain Analysis Model"
    },
    {
      "identity" : "rim",
      "uri" : "http://hl7.org/v3",
      "name" : "RIM Mapping"
    },
    {
      "identity" : "w5",
      "uri" : "http://hl7.org/fhir/w5",
      "name" : "W5 Mapping"
    },
    {
      "identity" : "v2",
      "uri" : "http://hl7.org/v2",
      "name" : "HL7 v2 Mapping"
    }
  ],
  "kind" : "resource",
  "abstract" : false,
  "type" : "Specimen",
  "baseDefinition" : "http://hl7.org/fhir/StructureDefinition/Specimen",
  "derivation" : "constraint",
  "snapshot" : {
    "element" : [
      {
        "id" : "Specimen",
        "path" : "Specimen",
        "short" : "Sample for analysis",
        "definition" : "A sample to be used for analysis.",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Specimen",
          "min" : 0,
          "max" : "*"
        },
        "constraint" : [
          {
            "key" : "dom-2",
            "severity" : "error",
            "human" : "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
            "expression" : "contained.contained.empty()",
            "xpath" : "not(parent::f:contained and f:contained)",
            "source" : "DomainResource"
          },
          {
            "key" : "dom-1",
            "severity" : "error",
            "human" : "If the resource is contained in another resource, it SHALL NOT contain any narrative",
            "expression" : "contained.text.empty()",
            "xpath" : "not(parent::f:contained and f:text)",
            "source" : "DomainResource"
          },
          {
            "key" : "dom-4",
            "severity" : "error",
            "human" : "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
            "expression" : "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
            "xpath" : "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
            "source" : "DomainResource"
          },
          {
            "key" : "dom-3",
            "severity" : "error",
            "human" : "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource",
            "expression" : "contained.where(('#'+id in %resource.descendants().reference).not()).empty()",
            "xpath" : "not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))",
            "source" : "DomainResource"
          }
        ],
        "mustSupport" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "Entity. Role, or Act"
          },
          {
            "identity" : "rim",
            "map" : "Role[classCode=SPEC]"
          },
          {
            "identity" : "w5",
            "map" : "clinical.diagnostics"
          }
        ]
      },
      {
        "id" : "Specimen.id",
        "path" : "Specimen.id",
        "short" : "Logical id of this artifact",
        "definition" : "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
        "comment" : "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Resource.id",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "id"
          }
        ],
        "isSummary" : true
      },
      {
        "id" : "Specimen.meta",
        "path" : "Specimen.meta",
        "short" : "Metadata about the resource",
        "definition" : "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Resource.meta",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "Meta"
          }
        ],
        "isSummary" : true
      },
      {
        "id" : "Specimen.implicitRules",
        "path" : "Specimen.implicitRules",
        "short" : "A set of rules under which this content was created",
        "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.",
        "comment" : "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. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Resource.implicitRules",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "uri"
          }
        ],
        "isModifier" : true,
        "isSummary" : true
      },
      {
        "id" : "Specimen.language",
        "path" : "Specimen.language",
        "short" : "Language of the resource content",
        "definition" : "The base language in which the resource is written.",
        "comment" : "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource  Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Resource.language",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "code"
          }
        ],
        "binding" : {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
              "valueReference" : {
                "reference" : "http://hl7.org/fhir/ValueSet/all-languages"
              }
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString" : "Language"
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
              "valueBoolean" : true
            }
          ],
          "strength" : "extensible",
          "description" : "A human language.",
          "valueSetReference" : {
            "reference" : "http://hl7.org/fhir/ValueSet/languages"
          }
        }
      },
      {
        "id" : "Specimen.text",
        "path" : "Specimen.text",
        "short" : "Text summary of the resource, for human interpretation",
        "definition" : "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"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.",
        "comment" : "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 in formation is added later.",
        "alias" : [
          "narrative",
          "html",
          "xhtml",
          "display"
        ],
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "DomainResource.text",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "Narrative"
          }
        ],
        "condition" : [
          "dom-1"
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "Act.text?"
          }
        ]
      },
      {
        "id" : "Specimen.contained",
        "path" : "Specimen.contained",
        "short" : "Contained, inline Resources",
        "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.",
        "comment" : "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
        "alias" : [
          "inline resources",
          "anonymous resources",
          "contained resources"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "DomainResource.contained",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Resource"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "N/A"
          }
        ]
      },
      {
        "id" : "Specimen.extension",
        "path" : "Specimen.extension",
        "short" : "Additional Content defined by implementations",
        "definition" : "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
        "comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
        "alias" : [
          "extensions",
          "user content"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "DomainResource.extension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "N/A"
          }
        ]
      },
      {
        "id" : "Specimen.modifierExtension",
        "path" : "Specimen.modifierExtension",
        "short" : "Extensions that cannot be ignored",
        "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. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
        "comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
        "alias" : [
          "extensions",
          "user content"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "DomainResource.modifierExtension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ],
        "isModifier" : true,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "N/A"
          }
        ]
      },
      {
        "id" : "Specimen.identifier",
        "path" : "Specimen.identifier",
        "short" : "External Identifier",
        "definition" : "Id for specimen.",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Specimen.identifier",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Identifier"
          }
        ],
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "SPM-2"
          },
          {
            "identity" : "rim",
            "map" : ".id"
          },
          {
            "identity" : "w5",
            "map" : "id"
          }
        ]
      },
      {
        "id" : "Specimen.accessionIdentifier",
        "path" : "Specimen.accessionIdentifier",
        "short" : "Identifier assigned by the lab",
        "definition" : "The identifier assigned by the lab when accessioning specimen(s). This is not necessarily the same as the specimen identifier, depending on local lab procedures.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Specimen.accessionIdentifier",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "Identifier"
          }
        ],
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "SPM-30 (v2.7+)"
          },
          {
            "identity" : "rim",
            "map" : ".participation[typeCode=SBJ].act[classCode=ACSN, moodCode=EVN].id"
          },
          {
            "identity" : "w5",
            "map" : "id"
          }
        ]
      },
      {
        "id" : "Specimen.status",
        "path" : "Specimen.status",
        "short" : "available | unavailable | unsatisfactory | entered-in-error",
        "definition" : "The availability of the specimen.",
        "comment" : "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Specimen.status",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "code"
          }
        ],
        "isModifier" : true,
        "isSummary" : true,
        "binding" : {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString" : "SpecimenStatus"
            }
          ],
          "strength" : "required",
          "description" : "Codes providing the status/availability of a specimen.",
          "valueSetReference" : {
            "reference" : "http://hl7.org/fhir/ValueSet/specimen-status"
          }
        },
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "SPM-20"
          },
          {
            "identity" : "rim",
            "map" : "status"
          },
          {
            "identity" : "w5",
            "map" : "status"
          }
        ]
      },
      {
        "id" : "Specimen.type",
        "path" : "Specimen.type",
        "short" : "Kind of material that forms the specimen",
        "definition" : "The kind of material that forms the specimen.",
        "comment" : "The type can change the way that a specimen is handled, and drives what kind of analyses can properly be performed on the specimen. It is frequently used in diagnostic work flow decision making systems.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Specimen.type",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ],
        "mustSupport" : true,
        "isSummary" : true,
        "binding" : {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString" : "SpecimenType"
            }
          ],
          "strength" : "example",
          "description" : "The type of the specimen.",
          "valueSetReference" : {
            "reference" : "http://hl7.org/fhir/ValueSet/v2-0487"
          }
        },
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "SPM-4 and possibly SPM-5"
          },
          {
            "identity" : "rim",
            "map" : ".code"
          },
          {
            "identity" : "w5",
            "map" : "what"
          }
        ]
      },
      {
        "id" : "Specimen.subject",
        "path" : "Specimen.subject",
        "short" : "Where the specimen came from. This may be from the patient(s) or from the environment or a device",
        "definition" : "Where the specimen came from. This may be from the patient(s) or from the environment or a device.",
        "requirements" : "Must know the subject context.",
        "min" : 1,
        "max" : "1",
        "base" : {
          "path" : "Specimen.subject",
          "min" : 1,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
          },
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-device"
          },
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-substance"
          },
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/StructureDefinition/Group"
          }
        ],
        "mustSupport" : true,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : ".scoper  or  .scoper.playsRole"
          },
          {
            "identity" : "w5",
            "map" : "who.focus"
          }
        ]
      },
      {
        "id" : "Specimen.receivedTime",
        "path" : "Specimen.receivedTime",
        "short" : "The time when specimen was received for processing",
        "definition" : "Time when specimen was received for processing or testing.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Specimen.receivedTime",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "dateTime"
          }
        ],
        "mustSupport" : true,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "SPM-18"
          },
          {
            "identity" : "rim",
            "map" : ".participation[typeCode=SBJ].act[code=SPCREC, moodCode=EVN].effectiveTime"
          },
          {
            "identity" : "w5",
            "map" : "when.done"
          }
        ]
      },
      {
        "id" : "Specimen.parent",
        "path" : "Specimen.parent",
        "short" : "Specimen from which this specimen originated",
        "definition" : "Reference to the parent (source) specimen which is used when the specimen was either derived from or a component of another specimen.",
        "comment" : "The parent specimen could be the source from which the current specimen is derived by some processing step (e.g. an aliquot or isolate or extracted nucleic acids from clinical samples) or one of many specimens that were combined to create a pooled sample.",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Specimen.parent",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-specimen"
          }
        ],
        "mustSupport" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : ".scoper (if parent) .player.scopesRole[classCode=SPEC].player (if child)"
          }
        ]
      },
      {
        "id" : "Specimen.request",
        "path" : "Specimen.request",
        "short" : "Why the specimen was collected",
        "definition" : "Details concerning a test or procedure request that required a specimen to be collected.",
        "comment" : "The request may be explicit or implied such with a ProcedureRequest that requires a blood draw.",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Specimen.request",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/StructureDefinition/ProcedureRequest"
          }
        ],
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "ORC? OBR-2/3?"
          },
          {
            "identity" : "rim",
            "map" : "outboundRelationship[typeCode=FLFS].target"
          },
          {
            "identity" : "w5",
            "map" : "why"
          }
        ]
      },
      {
        "id" : "Specimen.collection",
        "path" : "Specimen.collection",
        "short" : "Collection details",
        "definition" : "Details concerning the specimen collection.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Specimen.collection",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "BackboneElement"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() | (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "Element"
          }
        ],
        "mustSupport" : false,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "SPM-14"
          },
          {
            "identity" : "rim",
            "map" : ".participation[typeCode=SBJ].act[classCode=SPECCOLLECT, moodCode=EVN]"
          }
        ]
      },
      {
        "id" : "Specimen.collection.id",
        "path" : "Specimen.collection.id",
        "representation" : [
          "xmlAttr"
        ],
        "short" : "xml:id (or equivalent in JSON)",
        "definition" : "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Element.id",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "string"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "Specimen.collection.extension",
        "path" : "Specimen.collection.extension",
        "short" : "Additional Content defined by implementations",
        "definition" : "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
        "comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
        "alias" : [
          "extensions",
          "user content"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Element.extension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "Specimen.collection.modifierExtension",
        "path" : "Specimen.collection.modifierExtension",
        "short" : "Extensions that cannot be ignored",
        "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 that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
        "comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
        "alias" : [
          "extensions",
          "user content",
          "modifiers"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "BackboneElement.modifierExtension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ],
        "isModifier" : true,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "N/A"
          }
        ]
      },
      {
        "id" : "Specimen.collection.collector",
        "path" : "Specimen.collection.collector",
        "short" : "Who collected the specimen",
        "definition" : "Person who collected the specimen.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Specimen.collection.collector",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner"
          }
        ],
        "mustSupport" : false,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "PRT"
          },
          {
            "identity" : "rim",
            "map" : ".participation[typeCode=PFM].role"
          },
          {
            "identity" : "w5",
            "map" : "who.actor"
          }
        ]
      },
      {
        "id" : "Specimen.collection.collected[x]",
        "path" : "Specimen.collection.collected[x]",
        "short" : "Collection time",
        "definition" : "Time when specimen was collected from subject - the physiologically relevant time.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Specimen.collection.collected[x]",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "dateTime"
          },
          {
            "code" : "Period"
          }
        ],
        "mustSupport" : true,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "SPM-17"
          },
          {
            "identity" : "rim",
            "map" : ".effectiveTime"
          },
          {
            "identity" : "w5",
            "map" : "when.init"
          }
        ]
      },
      {
        "id" : "Specimen.collection.quantity",
        "path" : "Specimen.collection.quantity",
        "short" : "The quantity of specimen collected",
        "definition" : "The quantity of specimen collected; for instance the volume of a blood sample, or the physical measurement of an anatomic pathology sample.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Specimen.collection.quantity",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "Quantity",
            "profile" : "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
          }
        ],
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "SPM-12"
          },
          {
            "identity" : "rim",
            "map" : ".participation[typeCode=SBJ].role[classCode=SPEC].player.quantity"
          }
        ]
      },
      {
        "id" : "Specimen.collection.method",
        "path" : "Specimen.collection.method",
        "short" : "Technique used to perform collection",
        "definition" : "A coded value specifying the technique that is used to perform the procedure.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Specimen.collection.method",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ],
        "binding" : {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString" : "SpecimenCollectionMethod"
            }
          ],
          "strength" : "example",
          "description" : "The  technique that is used to perform the procedure",
          "valueSetReference" : {
            "reference" : "http://hl7.org/fhir/ValueSet/specimen-collection-method"
          }
        },
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "SPM-7"
          },
          {
            "identity" : "rim",
            "map" : ".methodCode"
          }
        ]
      },
      {
        "id" : "Specimen.collection.bodySite",
        "path" : "Specimen.collection.bodySite",
        "short" : "Anatomical collection site",
        "definition" : "Anatomical location from which the specimen was collected (if subject is a patient). This is the target site.  This element is not used for environmental specimens.",
        "comment" : "If the use case requires  BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately)  then use the standard extension [body-site-instance](http://hl7.org/fhir/STU3/extension-body-site-instance.html).",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Specimen.collection.bodySite",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ],
        "mustSupport" : true,
        "binding" : {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString" : "BodySite"
            }
          ],
          "strength" : "example",
          "description" : "Codes describing anatomical locations. May include laterality.",
          "valueSetReference" : {
            "reference" : "http://hl7.org/fhir/ValueSet/body-site"
          }
        },
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "SPM-8 and SPM-9"
          },
          {
            "identity" : "rim",
            "map" : ".targetSiteCode"
          }
        ]
      },
      {
        "id" : "Specimen.processing",
        "path" : "Specimen.processing",
        "short" : "Processing and processing step details",
        "definition" : "Details concerning processing and processing steps for the specimen.",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Specimen.processing",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "BackboneElement"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() | (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "Element"
          }
        ],
        "mustSupport" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : ".participation[typeCode=SBJ].act[code=SPCTRT, moodCode=EVN]"
          }
        ]
      },
      {
        "id" : "Specimen.processing.id",
        "path" : "Specimen.processing.id",
        "representation" : [
          "xmlAttr"
        ],
        "short" : "xml:id (or equivalent in JSON)",
        "definition" : "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Element.id",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "string"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "Specimen.processing.extension",
        "path" : "Specimen.processing.extension",
        "short" : "Additional Content defined by implementations",
        "definition" : "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
        "comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
        "alias" : [
          "extensions",
          "user content"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Element.extension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "Specimen.processing.modifierExtension",
        "path" : "Specimen.processing.modifierExtension",
        "short" : "Extensions that cannot be ignored",
        "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 that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
        "comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
        "alias" : [
          "extensions",
          "user content",
          "modifiers"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "BackboneElement.modifierExtension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ],
        "isModifier" : true,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "N/A"
          }
        ]
      },
      {
        "id" : "Specimen.processing.description",
        "path" : "Specimen.processing.description",
        "short" : "Textual description of procedure",
        "definition" : "Textual description of procedure.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Specimen.processing.description",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "string"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : ".text"
          }
        ]
      },
      {
        "id" : "Specimen.processing.procedure",
        "path" : "Specimen.processing.procedure",
        "short" : "Indicates the treatment step  applied to the specimen",
        "definition" : "A coded value specifying the procedure used to process the specimen.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Specimen.processing.procedure",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ],
        "mustSupport" : true,
        "binding" : {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString" : "SpecimenProcessingProcedure"
            }
          ],
          "strength" : "example",
          "description" : "Type indicating the technique used to process the specimen",
          "valueSetReference" : {
            "reference" : "http://hl7.org/fhir/ValueSet/specimen-processing-procedure"
          }
        },
        "mapping" : [
          {
            "identity" : "rim",
            "map" : ".code"
          }
        ]
      },
      {
        "id" : "Specimen.processing.additive",
        "path" : "Specimen.processing.additive",
        "short" : "Material used in the processing step",
        "definition" : "Material used in the processing step.",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Specimen.processing.additive",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-substance"
          }
        ],
        "mustSupport" : false,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "SPM-6"
          },
          {
            "identity" : "rim",
            "map" : ".participation[typeCode=CSM].role[classCode=ADTV].code"
          }
        ]
      },
      {
        "id" : "Specimen.processing.time[x]",
        "path" : "Specimen.processing.time[x]",
        "short" : "Date and time of specimen processing",
        "definition" : "A record of the time or period when the specimen processing occurred.  For example the time of sample fixation or the period of time the sample was in formalin.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Specimen.processing.time[x]",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "dateTime"
          },
          {
            "code" : "Period"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : ".effectiveTime"
          }
        ]
      },
      {
        "id" : "Specimen.container",
        "path" : "Specimen.container",
        "short" : "Direct container of specimen (tube/slide, etc.)",
        "definition" : "The container holding the specimen.  The recursive nature of containers; i.e. blood in tube in tray in rack is not addressed here.",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Specimen.container",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "BackboneElement"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() | (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "Element"
          }
        ],
        "mustSupport" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : ".player.scopingRole[classCode=CONT].scoper"
          }
        ]
      },
      {
        "id" : "Specimen.container.id",
        "path" : "Specimen.container.id",
        "representation" : [
          "xmlAttr"
        ],
        "short" : "xml:id (or equivalent in JSON)",
        "definition" : "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Element.id",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "string"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "Specimen.container.extension",
        "path" : "Specimen.container.extension",
        "slicing" : {
          "id" : "15",
          "discriminator" : [
            {
              "type" : "value",
              "path" : "url"
            }
          ],
          "ordered" : false,
          "rules" : "open"
        },
        "short" : "Extension",
        "definition" : "An Extension",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Element.extension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ]
      },
      {
        "id" : "Specimen.container.extension:container-sequenceNumber",
        "path" : "Specimen.container.extension",
        "sliceName" : "container-sequenceNumber",
        "short" : "The sequence number of the sample",
        "definition" : "An assigned number on the specimen denoting the order of collection.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Element.extension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension",
            "profile" : "http://hl7.org/fhir/StructureDefinition/specimen-sequenceNumber"
          }
        ],
        "condition" : [
          "ele-1"
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() | (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "Element"
          },
          {
            "key" : "ext-1",
            "severity" : "error",
            "human" : "Must have either extensions or value[x], not both",
            "expression" : "extension.exists() != value.exists()",
            "xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
            "source" : "Extension"
          }
        ],
        "mustSupport" : false,
        "isModifier" : false,
        "mapping" : [
          {
            "identity" : "qidam",
            "map" : "Not in QIDAM, but recognized as important since there are labs where the sequence of the collection is important (e.g., knowing that 1 is the first sample, 2 is the second, etc.)."
          }
        ]
      },
      {
        "id" : "Specimen.container.modifierExtension",
        "path" : "Specimen.container.modifierExtension",
        "short" : "Extensions that cannot be ignored",
        "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 that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
        "comment" : "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
        "alias" : [
          "extensions",
          "user content",
          "modifiers"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "BackboneElement.modifierExtension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ],
        "isModifier" : true,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "N/A"
          }
        ]
      },
      {
        "id" : "Specimen.container.identifier",
        "path" : "Specimen.container.identifier",
        "short" : "Id for the container",
        "definition" : "Id for container. There may be multiple; a manufacturer's bar code, lab assigned identifier, etc. The container ID may differ from the specimen id in some circumstances.",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Specimen.container.identifier",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Identifier"
          }
        ],
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "SAC-3"
          },
          {
            "identity" : "rim",
            "map" : ".id"
          }
        ]
      },
      {
        "id" : "Specimen.container.description",
        "path" : "Specimen.container.description",
        "short" : "Textual description of the container",
        "definition" : "Textual description of the container.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Specimen.container.description",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "string"
          }
        ],
        "mapping" : [
          {
            "identity" : "rim",
            "map" : ".desc"
          }
        ]
      },
      {
        "id" : "Specimen.container.type",
        "path" : "Specimen.container.type",
        "short" : "Kind of container directly associated with specimen",
        "definition" : "The type of container associated with the specimen (e.g. slide, aliquot, etc.).",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Specimen.container.type",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ],
        "binding" : {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString" : "SpecimenContainerType"
            }
          ],
          "strength" : "example",
          "description" : "Type of specimen container",
          "valueSetReference" : {
            "reference" : "http://hl7.org/fhir/ValueSet/specimen-container-type"
          }
        },
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "SPM-27"
          },
          {
            "identity" : "rim",
            "map" : ".code"
          }
        ]
      },
      {
        "id" : "Specimen.container.capacity",
        "path" : "Specimen.container.capacity",
        "short" : "Container volume or size",
        "definition" : "The capacity (volume or other measure) the container may contain.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Specimen.container.capacity",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "Quantity",
            "profile" : "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
          }
        ],
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "one of: SAC 16, SAC17 and SAC 20, or SAC 21 and SAC 20"
          },
          {
            "identity" : "rim",
            "map" : ".quantity"
          }
        ]
      },
      {
        "id" : "Specimen.container.specimenQuantity",
        "path" : "Specimen.container.specimenQuantity",
        "short" : "Quantity of specimen within container",
        "definition" : "The quantity of specimen in the container; may be volume, dimensions, or other appropriate measurements, depending on the specimen type.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Specimen.container.specimenQuantity",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "Quantity",
            "profile" : "http://hl7.org/fhir/StructureDefinition/SimpleQuantity"
          }
        ],
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "SAC-23 (value) SAC-24 (units"
          },
          {
            "identity" : "rim",
            "map" : ".playedRole[classCode=CONT].quantity"
          }
        ]
      },
      {
        "id" : "Specimen.container.additive[x]",
        "path" : "Specimen.container.additive[x]",
        "short" : "Additive associated with container",
        "definition" : "Introduced substance to preserve, maintain or enhance the specimen. Examples: Formalin, Citrate, EDTA.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Specimen.container.additive[x]",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "CodeableConcept"
          },
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-substance"
          }
        ],
        "mustSupport" : false,
        "binding" : {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString" : "SpecimenContainerAdditive"
            }
          ],
          "strength" : "example",
          "description" : "Substance added to specimen container",
          "valueSetReference" : {
            "reference" : "http://hl7.org/fhir/ValueSet/v2-0371"
          }
        },
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "SAC-27"
          },
          {
            "identity" : "rim",
            "map" : ".scopesRole[classCode=ADTV].player"
          }
        ]
      },
      {
        "id" : "Specimen.note",
        "path" : "Specimen.note",
        "short" : "Comments",
        "definition" : "To communicate any details or issues about the specimen or during the specimen collection. (for example: broken vial, sent with patient, frozen).",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Specimen.note",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Annotation"
          }
        ],
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "OBX"
          },
          {
            "identity" : "rim",
            "map" : ".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=\"annotation\"].value"
          }
        ]
      }
    ]
  },
  "differential" : {
    "element" : [
      {
        "id" : "Specimen",
        "path" : "Specimen",
        "mustSupport" : false,
        "isModifier" : false
      },
      {
        "id" : "Specimen.type",
        "path" : "Specimen.type",
        "mustSupport" : true,
        "isModifier" : false
      },
      {
        "id" : "Specimen.subject",
        "path" : "Specimen.subject",
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"
          },
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-device"
          },
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-substance"
          },
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/StructureDefinition/Group"
          }
        ],
        "mustSupport" : true,
        "isModifier" : false
      },
      {
        "id" : "Specimen.receivedTime",
        "path" : "Specimen.receivedTime",
        "mustSupport" : true,
        "isModifier" : false
      },
      {
        "id" : "Specimen.parent",
        "path" : "Specimen.parent",
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-specimen"
          }
        ],
        "mustSupport" : false,
        "isModifier" : false
      },
      {
        "id" : "Specimen.collection",
        "path" : "Specimen.collection",
        "mustSupport" : false,
        "isModifier" : false
      },
      {
        "id" : "Specimen.collection.collector",
        "path" : "Specimen.collection.collector",
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner"
          }
        ],
        "mustSupport" : false,
        "isModifier" : false
      },
      {
        "id" : "Specimen.collection.collected[x]",
        "path" : "Specimen.collection.collected[x]",
        "mustSupport" : true,
        "isModifier" : false
      },
      {
        "id" : "Specimen.collection.bodySite",
        "path" : "Specimen.collection.bodySite",
        "mustSupport" : true,
        "isModifier" : false
      },
      {
        "id" : "Specimen.processing",
        "path" : "Specimen.processing",
        "mustSupport" : false,
        "isModifier" : false
      },
      {
        "id" : "Specimen.processing.procedure",
        "path" : "Specimen.processing.procedure",
        "mustSupport" : true,
        "isModifier" : false
      },
      {
        "id" : "Specimen.processing.additive",
        "path" : "Specimen.processing.additive",
        "type" : [
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-substance"
          }
        ],
        "mustSupport" : false,
        "isModifier" : false
      },
      {
        "id" : "Specimen.container",
        "path" : "Specimen.container",
        "mustSupport" : false,
        "isModifier" : false
      },
      {
        "id" : "Specimen.container.extension:container-sequenceNumber",
        "path" : "Specimen.container.extension",
        "sliceName" : "container-sequenceNumber",
        "min" : 0,
        "max" : "1",
        "type" : [
          {
            "code" : "Extension",
            "profile" : "http://hl7.org/fhir/StructureDefinition/specimen-sequenceNumber"
          }
        ],
        "mustSupport" : false,
        "isModifier" : false,
        "mapping" : [
          {
            "identity" : "qidam",
            "map" : "Not in QIDAM, but recognized as important since there are labs where the sequence of the collection is important (e.g., knowing that 1 is the first sample, 2 is the second, etc.)."
          }
        ]
      },
      {
        "id" : "Specimen.container.additive[x]",
        "path" : "Specimen.container.additive[x]",
        "type" : [
          {
            "code" : "CodeableConcept"
          },
          {
            "code" : "Reference",
            "targetProfile" : "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-substance"
          }
        ],
        "mustSupport" : false,
        "isModifier" : false
      }
    ]
  }
}