Respiratory Virus Hospitalization Surveillance Network (RESP-NET) Content Implementation Guide
2.0.0-ballot - STU 2 - Ballot United States of America flag

This page is part of the Respiratory Virus Hospitalization Surveillance Network (RESP-NET) Content Implementation Guide (v2.0.0-ballot: STU2 Ballot) based on FHIR (HL7® FHIR® Standard) R4. This version is a pre-release. The current official version is 1.0.0. For a full list of available versions, see the Directory of published versions

Resource Profile: RESPNETComposition - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 2

Definitions for the resp-net-composition resource profile.

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

0. Composition
Definition

The RESP-NET Composition profile establishes the core elements, extensions, vocabularies and value sets for representing RESP-NET report.

ShortResp-net Composition Profile
Is Modifierfalse
Must Supporttrue
2. Composition.extension:respnet-report-context
Slice Namerespnet-report-context
Control1..1
TypeExtension(RESP-NET Report Context Extension) (Extension Type: CodeableConcept)
Must Supporttrue
4. Composition.identifier
Definition

RESP-NET Composition identifier. This is equivalent to ClinicalDocument.setId in CDA. The identifier of the containing Bundle is equivalent to ClinicalDocument.id in CDA.

ShortRESP-NET Composition identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..1
Must Supporttrue
6. Composition.status
Must Supporttrue
Fixed Valuefinal
8. Composition.type
Definition

The type of this Composition is a RESP-NET Report

ShortRESP-NET Report
Must Supporttrue
Pattern Value{
  "coding" : [{
    "system" : "http://loinc.org",
    "code" : "55751-2"
  }]
}
10. Composition.subject
Definition

This Patient profile represents the subject of the RESP-NET report.

ShortPatient who is the subject of the report.
Control1..?
TypeReference(US Public Health Patient)
Is Modifierfalse
Must Supporttrue
12. Composition.encounter
Definition

This Encounter profile represents the encounter related to the RESP-NET report.

ShortEncounter related to the public health event
Control1..?
TypeReference(US Public Health Encounter)
Is Modifierfalse
Must Supporttrue
14. Composition.date
Is Modifierfalse
Must Supporttrue
16. Composition.author
Definition

It is possible to have multiple authors - especially in the case where the default author is the organization. Author information can contain the HDEA/BSA as a Device Author.

ShortThe author(s) of the document
Control0..*
TypeReference(US Core PractitionerRole Profile, US Core Practitioner Profile, US Core Organization Profile, Device)
Is Modifierfalse
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
18. Composition.title
Must Supporttrue
Fixed ValueRESP-NET Report
20. Composition.section
Must Supporttrue
SlicingThis element introduces a set of slices on Composition.section. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ code
  • 22. Composition.section:sliceEncounterSection
    Slice NamesliceEncounterSection
    Definition

    This section lists and describes all the patient's encounter information related to the encounter.

    ShortEncounter Section
    Control1..1
    Is Modifierfalse
    Must Supporttrue
    24. Composition.section:sliceEncounterSection.code
    Definition

    Encounter Section code

    ShortEncounter Section code
    Control1..?
    Is Modifierfalse
    Must Supporttrue
    Pattern Value{
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "67781-5"
      }]
    }
    26. Composition.section:sliceEncounterSection.text
    Definition

    Encounter Section narrative

    ShortEncounter Section narrative
    Control1..?
    Must Supporttrue
    28. Composition.section:sliceEncounterSection.entry
    Must Supporttrue
    SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • profile @ resolve()
    • 30. Composition.section:sliceEncounterSection.entry:sliceEncounter
      Slice NamesliceEncounter
      ShortEncounter Entry
      TypeReference(US Public Health Encounter)
      Is Modifierfalse
      Must Supporttrue
      32. Composition.section:sliceEncounterSection.entry:sliceEncounterDiagnosis
      Slice NamesliceEncounterDiagnosis
      ShortEncounter Diagnosis Entry
      TypeReference(US Core Condition Encounter Diagnosis Profile)
      Is Modifierfalse
      Must Supporttrue
      34. Composition.section:sliceProblemSection
      Slice NamesliceProblemSection
      Definition

      This section lists and describes all the patient's current problems on the maintained problem list.

      ShortProblem Section
      Control0..1
      Is Modifierfalse
      Must Supporttrue
      36. Composition.section:sliceProblemSection.code
      Definition

      Problem Section code

      ShortProblem Section code
      Control1..?
      Is Modifierfalse
      Must Supporttrue
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "11450-4"
        }]
      }
      38. Composition.section:sliceProblemSection.text
      Definition

      Problem Section narrative

      ShortProblem Section narrative
      Control1..?
      Must Supporttrue
      40. Composition.section:sliceProblemSection.entry
      Must Supporttrue
      SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • profile @ resolve()
      • 42. Composition.section:sliceProblemSection.entry:sliceCondition
        Slice NamesliceCondition
        ShortCondition Entry
        TypeReference(US Public Health Condition)
        Is Modifierfalse
        Must Supporttrue
        44. Composition.section:sliceProblemSection.entry:sliceProblemHealthConcern
        Slice NamesliceProblemHealthConcern
        ShortProblem Health Concern Entry
        TypeReference(US Core Condition Problems and Health Concerns Profile)
        Is Modifierfalse
        Must Supporttrue
        46. Composition.section:sliceMedicationsAdministeredSection
        Slice NamesliceMedicationsAdministeredSection
        Definition

        The Medications Administered Section defines medications administered during the encounter.

        ShortMedications Administered Section
        Control0..1
        Is Modifierfalse
        Must Supporttrue
        48. Composition.section:sliceMedicationsAdministeredSection.code
        Definition

        Medications Administered Section code

        ShortMedications Administered Section code
        Control1..?
        Is Modifierfalse
        Must Supporttrue
        Pattern Value{
          "coding" : [{
            "system" : "http://loinc.org",
            "code" : "29549-3"
          }]
        }
        50. Composition.section:sliceMedicationsAdministeredSection.text
        Definition

        Medications Administered Section narrative

        ShortMedications Administered Section narrative
        Control1..?
        Must Supporttrue
        52. Composition.section:sliceMedicationsAdministeredSection.entry
        Must Supporttrue
        SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • profile @ resolve()
        • 54. Composition.section:sliceMedicationsAdministeredSection.entry:sliceMedicationAdministration
          Slice NamesliceMedicationAdministration
          ShortMedication Administration Entry
          TypeReference(US Public Health MedicationAdministration)
          Is Modifierfalse
          Must Supporttrue
          56. Composition.section:sliceMedicationsAdministeredSection.entry:sliceMedicationReferences
          Slice NamesliceMedicationReferences
          ShortMedication Reference Entry
          TypeReference(US Core Medication Profile)
          Is Modifierfalse
          Must Supporttrue
          58. Composition.section:sliceMedicationsSection
          Slice NamesliceMedicationsSection
          Definition

          The Medications Section contains a patient's current medications and pertinent medication history. At a minimum, the currently active medications are listed.

          ShortMedications Section
          Control0..1
          Is Modifierfalse
          Must Supporttrue
          60. Composition.section:sliceMedicationsSection.code
          Definition

          Medications Section code

          ShortMedications Section code
          Control1..?
          Is Modifierfalse
          Must Supporttrue
          Pattern Value{
            "coding" : [{
              "system" : "http://loinc.org",
              "code" : "10160-0"
            }]
          }
          62. Composition.section:sliceMedicationsSection.text
          Definition

          Medications Section narrative

          ShortMedications Section narrative
          Control1..?
          Must Supporttrue
          64. Composition.section:sliceMedicationsSection.entry
          Must Supporttrue
          SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • profile @ resolve()
          • 66. Composition.section:sliceMedicationsSection.entry:sliceMedicationAdministration
            Slice NamesliceMedicationAdministration
            ShortMedication Administration Entry
            TypeReference(US Public Health MedicationAdministration)
            Is Modifierfalse
            Must Supporttrue
            68. Composition.section:sliceMedicationsSection.entry:sliceMedicationStatement
            Slice NamesliceMedicationStatement
            ShortMedication Statement Entry
            TypeReference(RESP-NET Medication Statement)
            Is Modifierfalse
            Must Supporttrue
            70. Composition.section:sliceMedicationsSection.entry:sliceMedicationReferences
            Slice NamesliceMedicationReferences
            ShortMedication Reference Entry
            TypeReference(US Core Medication Profile)
            Is Modifierfalse
            Must Supporttrue
            72. Composition.section:sliceResultsSection
            Slice NamesliceResultsSection
            Definition

            The Results Section contains observations of results generated by laboratories, imaging procedures, and other procedures. The scope includes observations such as hematology, chemistry, serology, virology, toxicology, microbiology, plain x-ray, ultrasound, CT, MRI, angiography, echocardiography, nuclear medicine, pathology, and procedure observations. The section often includes notable results such as abnormal values or relevant trends, and could contain all results for the period of time being documented.

            Laboratory results are typically generated by laboratories providing analytic services in areas such as chemistry, hematology, serology, histology, cytology, anatomic pathology, microbiology, and/or virology. These observations are based on analysis of specimens obtained from the patient and submitted to the laboratory. Imaging results are typically generated by a clinician reviewing the output of an imaging procedure, such as where a cardiologist reports the left ventricular ejection fraction based on the review of a cardiac echocardiogram.

            Procedure results are typically generated by a clinician to provide more granular information about component observations made during a procedure, such as where a gastroenterologist reports the size of a polyp observed during a colonoscopy.

            ShortResults Section
            Control1..1
            Is Modifierfalse
            Must Supporttrue
            74. Composition.section:sliceResultsSection.code
            Definition

            Results Section code

            ShortResults Section code
            Control1..?
            Is Modifierfalse
            Must Supporttrue
            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "30954-2"
              }]
            }
            76. Composition.section:sliceResultsSection.text
            Definition

            Results Section narrative

            ShortResults Section narrative
            Control1..?
            Must Supporttrue
            78. Composition.section:sliceResultsSection.entry
            Must Supporttrue
            SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • profile @ resolve()
            • 80. Composition.section:sliceResultsSection.entry:observationEntries
              Slice NameobservationEntries
              ShortObservation Entries
              TypeReference(US Public Health Laboratory Result Observation Profile, US Core Observation Clinical Result Profile, US Core Simple Observation Profile)
              Is Modifierfalse
              Must Supporttrue
              Must Support TypesNo must-support rules about the choice of types/profiles
              82. Composition.section:sliceResultsSection.entry:sliceDiagnosticResultEntry
              Slice NamesliceDiagnosticResultEntry
              ShortDiagnostic Result Entry
              TypeReference(US Core DiagnosticReport Profile for Laboratory Results Reporting)
              Is Modifierfalse
              Must Supporttrue
              84. Composition.section:sliceNotesSection
              Slice NamesliceNotesSection
              Definition

              The Notes Section contains clinical notes and diagnostic reports.

              ShortClinical and Diagnostic Reports Section
              Control0..1
              Is Modifierfalse
              Must Supporttrue
              86. Composition.section:sliceNotesSection.code
              Definition

              Clinical Notes Section code

              ShortClinical Notes Section code
              Control1..?
              Is Modifierfalse
              Must Supporttrue
              Pattern Value{
                "coding" : [{
                  "system" : "http://loinc.org",
                  "code" : "28650-0"
                }]
              }
              88. Composition.section:sliceNotesSection.text
              Definition

              Notes Section narrative

              ShortNotes Section narrative
              Control1..?
              Must Supporttrue
              90. Composition.section:sliceNotesSection.entry
              Must Supporttrue
              SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • profile @ resolve()
              • 92. Composition.section:sliceNotesSection.entry:sliceDocumentReferenceEntry
                Slice NamesliceDocumentReferenceEntry
                ShortDocument Reference Entry
                TypeReference(US Core DocumentReference Profile)
                Is Modifierfalse
                Must Supporttrue
                94. Composition.section:sliceNotesSection.entry:sliceDiagnosticReportEntry
                Slice NamesliceDiagnosticReportEntry
                ShortDiagnostic Report Entry
                TypeReference(US Core DiagnosticReport Profile for Report and Note Exchange)
                Is Modifierfalse
                Must Supporttrue
                96. Composition.section:slicePlanOfTreatmentSection
                Slice NameslicePlanOfTreatmentSection
                Definition

                This section, contains data that define pending orders, interventions, encounters, services, and procedures for the patient. It is limited to prospective, unfulfilled, or incomplete orders and requests only. All active, incomplete, or pending orders, appointments, referrals, procedures, services, or any other pending event of clinical significance to the current care of the patient should be listed.

                ShortPlan of Treatment Section
                Control0..1
                Is Modifierfalse
                Must Supporttrue
                98. Composition.section:slicePlanOfTreatmentSection.code
                Definition

                Plan of Treatment code

                ShortPlan of Treatment code
                Control1..?
                Is Modifierfalse
                Must Supporttrue
                Pattern Value{
                  "coding" : [{
                    "system" : "http://loinc.org",
                    "code" : "18776-5"
                  }]
                }
                100. Composition.section:slicePlanOfTreatmentSection.text
                Definition

                Plan of Treatment narrative

                ShortPlan of Treatment narrative
                Control1..?
                Must Supporttrue
                102. Composition.section:slicePlanOfTreatmentSection.entry
                Must Supporttrue
                SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • profile @ resolve()
                • 104. Composition.section:slicePlanOfTreatmentSection.entry:sliceServiceRequests
                  Slice NamesliceServiceRequests
                  ShortService Request Entry
                  TypeReference(eICR ServiceRequest, US Core ServiceRequest Profile)
                  Is Modifierfalse
                  Must Supporttrue
                  Must Support TypesNo must-support rules about the choice of types/profiles
                  106. Composition.section:slicePlanOfTreatmentSection.entry:sliceMedicationRequest
                  Slice NamesliceMedicationRequest
                  ShortMedication Request Entry
                  TypeReference(US Core MedicationRequest Profile)
                  Is Modifierfalse
                  Must Supporttrue
                  108. Composition.section:slicePlanOfTreatmentSection.entry:sliceMedicationReferences
                  Slice NamesliceMedicationReferences
                  ShortMedication Reference Entry
                  TypeReference(US Core Medication Profile)
                  Is Modifierfalse
                  Must Supporttrue
                  110. Composition.section:sliceImmunizationsSection
                  Slice NamesliceImmunizationsSection
                  Definition

                  The Immunizations Section defines a patient's current immunization status and pertinent immunization history. The primary use case for the Immunization Section is to enable communication of a patient's immunization status. The section should include current immunization status, and may contain the entire immunization history that is relevant to the period of time being summarized.

                  ShortImmunizations Section
                  Control0..1
                  Is Modifierfalse
                  Must Supporttrue
                  112. Composition.section:sliceImmunizationsSection.code
                  Definition

                  Immunizations code

                  ShortImmunizations code
                  Control1..?
                  Is Modifierfalse
                  Must Supporttrue
                  Pattern Value{
                    "coding" : [{
                      "system" : "http://loinc.org",
                      "code" : "11369-6"
                    }]
                  }
                  114. Composition.section:sliceImmunizationsSection.text
                  Definition

                  Immunizations narrative

                  ShortImmunizations narrative
                  Control1..?
                  Must Supporttrue
                  116. Composition.section:sliceImmunizationsSection.entry
                  Must Supporttrue
                  SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • profile @ resolve()
                  • 118. Composition.section:sliceImmunizationsSection.entry:sliceImmunizations
                    Slice NamesliceImmunizations
                    ShortImmunizations Entry
                    TypeReference(US Core Immunization Profile)
                    Is Modifierfalse
                    Must Supporttrue
                    120. Composition.section:sliceProceduresSection
                    Slice NamesliceProceduresSection
                    Definition

                    This section describes all interventional, surgical, diagnostic, or therapeutic procedures or treatments pertinent to the patient historically at the time the document is generated. The section should include notable procedures, but can contain all procedures for the period of time being summarized.

                    ShortThis section describes all interventional, surgical, diagnostic, or therapeutic procedures or treatments pertinent to the patient historically at the time the document is generated.
                    Control0..1
                    Is Modifierfalse
                    Must Supporttrue
                    122. Composition.section:sliceProceduresSection.code
                    Definition

                    Procedures Section code

                    ShortProcedures Section code
                    Control1..?
                    Is Modifierfalse
                    Must Supporttrue
                    Pattern Value{
                      "coding" : [{
                        "system" : "http://loinc.org",
                        "code" : "47519-4"
                      }]
                    }
                    124. Composition.section:sliceProceduresSection.text
                    Definition

                    Procedures Section narrative

                    ShortProcedures Section narrative
                    Control1..?
                    Must Supporttrue
                    126. Composition.section:sliceProceduresSection.entry
                    Must Supporttrue
                    SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • profile @ resolve()
                    • 128. Composition.section:sliceProceduresSection.entry:sliceProcedures
                      Slice NamesliceProcedures
                      ShortProcedures Entry
                      TypeReference(eICR Procedure)
                      Is Modifierfalse
                      Must Supporttrue
                      130. Composition.section:sliceVitalSignsSection
                      Slice NamesliceVitalSignsSection
                      Definition

                      The Vital Signs Section contains relevant vital signs for the eICR. The section should include notable vital signs such as the most recent, maximum and/or minimum, baseline, or relevant trends. Vital signs are represented in the same way as other results, but are aggregated into their own section to follow clinical conventions.

                      ShortVital Signs Section
                      Control0..1
                      Is Modifierfalse
                      Must Supporttrue
                      132. Composition.section:sliceVitalSignsSection.code
                      Definition

                      Vital Signs code

                      ShortVital Signs code
                      Control1..?
                      Is Modifierfalse
                      Must Supporttrue
                      Pattern Value{
                        "coding" : [{
                          "system" : "http://loinc.org",
                          "code" : "8716-3"
                        }]
                      }
                      134. Composition.section:sliceVitalSignsSection.text
                      Definition

                      Vital Signs narrative

                      ShortVital Signs narrative
                      Control1..?
                      Must Supporttrue
                      136. Composition.section:sliceVitalSignsSection.entry
                      Must Supporttrue
                      SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • profile @ resolve()
                      • 138. Composition.section:sliceVitalSignsSection.entry:sliceVitalSigns
                        Slice NamesliceVitalSigns
                        ShortVital Signs Entry
                        TypeReference(US Core Vital Signs Profile)
                        Is Modifierfalse
                        Must Supporttrue
                        140. Composition.section:sliceSocialHistorySection
                        Slice NamesliceSocialHistorySection
                        Definition

                        This section contains social history data that influence a patient’s physical, psychological or emotional health such as occupation, home environment, travel history, and disability status.

                        ShortSocial History Section
                        Control0..1
                        Is Modifierfalse
                        Must Supporttrue
                        142. Composition.section:sliceSocialHistorySection.code
                        Definition

                        Social History Section code

                        ShortSocial History Section code
                        Control1..?
                        Is Modifierfalse
                        Must Supporttrue
                        Pattern Value{
                          "coding" : [{
                            "system" : "http://loinc.org",
                            "code" : "29762-2"
                          }]
                        }
                        144. Composition.section:sliceSocialHistorySection.text
                        Definition

                        Social History Section narrative

                        ShortSocial History Section narrative
                        Control1..?
                        Must Supporttrue
                        146. Composition.section:sliceSocialHistorySection.entry
                        Must Supporttrue
                        SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • profile @ resolve()
                        • 148. Composition.section:sliceSocialHistorySection.entry:sliceSocialHistoryObservations
                          Slice NamesliceSocialHistoryObservations
                          Definition

                          Social History Observation entries

                          ShortSocial History Observations
                          TypeReference(US Core Smoking Status Observation Profile, US Public Health Disability Status, US Core Simple Observation Profile, US Public Health Characteristics of Home Environment)
                          Must Supporttrue
                          Must Support TypesNo must-support rules about the choice of types/profiles
                          150. Composition.section:slicePregnancySection
                          Slice NameslicePregnancySection
                          Definition

                          This section contains pregnancy data

                          ShortPregnancy Section
                          Control0..1
                          Is Modifierfalse
                          Must Supporttrue
                          152. Composition.section:slicePregnancySection.code
                          Definition

                          Pregnancy Section code

                          ShortPregnancy Section code
                          Control1..?
                          Is Modifierfalse
                          Must Supporttrue
                          Pattern Value{
                            "coding" : [{
                              "system" : "http://loinc.org",
                              "code" : "90767-5"
                            }]
                          }
                          154. Composition.section:slicePregnancySection.text
                          Definition

                          Pregnancy Section narrative

                          ShortPregnancy Section narrative
                          Control1..?
                          Must Supporttrue
                          156. Composition.section:slicePregnancySection.entry
                          Must Supporttrue
                          SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • profile @ resolve()
                          • 158. Composition.section:slicePregnancySection.entry:slicePregnancyOutcome
                            Slice NameslicePregnancyOutcome
                            Definition

                            Pregnancy Outcome entry

                            ShortPregnancy Outcome
                            TypeReference(US Public Health Pregnancy Outcome Observation)
                            Must Supporttrue
                            160. Composition.section:slicePregnancySection.entry:slicePregnancyStatusObservation
                            Slice NameslicePregnancyStatusObservation
                            Definition

                            Pregnancy Status Observation Entry

                            ShortPregnancy Status Observation
                            TypeReference(US Core Observation Pregnancy Status Profile)
                            Must Supporttrue
                            162. Composition.section:slicePregnancySection.entry:slicePostpartumStatus
                            Slice NameslicePostpartumStatus
                            Definition

                            Postpartum Status Entry

                            ShortPostpartum Status
                            TypeReference(US Public Health Postpartum Status)
                            Must Supporttrue

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

                            0. Composition
                            Definition

                            The RESP-NET Composition profile establishes the core elements, extensions, vocabularies and value sets for representing RESP-NET report.


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

                            ShortResp-net Composition ProfileA set of resources composed into a single coherent clinical statement with clinical attestation
                            Comments

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

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

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

                            ShortA set of rules under which this content was created
                            Comments

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

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

                            An Extension


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

                            ShortExtensionAdditional content defined by implementations
                            Comments

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

                            Control10..*
                            TypeExtension
                            Is Modifierfalse
                            Summaryfalse
                            Alternate Namesextensions, user content
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            SlicingThis element introduces a set of slices on Composition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 6. Composition.extension:respnet-report-context
                              Slice Namerespnet-report-context
                              Definition

                              Indicates the RESP-NET report context

                              ShortIndicates the RESP-NET report context
                              Control1..1
                              This element is affected by the following invariants: ele-1
                              TypeExtension(RESP-NET Report Context Extension) (Extension Type: CodeableConcept)
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              8. Composition.modifierExtension
                              Definition

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

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

                              ShortExtensions that cannot be ignored
                              Comments

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

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

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

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

                              RESP-NET Composition identifier. This is equivalent to ClinicalDocument.setId in CDA. The identifier of the containing Bundle is equivalent to ClinicalDocument.id in CDA.


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

                              ShortRESP-NET Composition identifierVersion-independent identifier for the Composition
                              Comments

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

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

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

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

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

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

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

                              The workflow/clinical status of the composition.

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

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

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

                              The type of this Composition is a RESP-NET Report


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

                              ShortRESP-NET ReportKind of composition (LOINC if possible)
                              Comments

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

                              Control1..1
                              BindingThe codes SHOULD be taken from FHIRDocumentTypeCodeshttp://hl7.org/fhir/ValueSet/doc-typecodes
                              (preferred to http://hl7.org/fhir/ValueSet/doc-typecodes)

                              Type of a composition.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supporttrue
                              Summarytrue
                              Requirements

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

                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://loinc.org",
                                  "code" : "55751-2"
                                }]
                              }
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              16. Composition.subject
                              Definition

                              This Patient profile represents the subject of the RESP-NET report.


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

                              ShortPatient who is the subject of the report.Who and/or what the composition is about
                              Comments

                              For clinical documents, this is usually the patient.

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

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

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

                              This Encounter profile represents the encounter related to the RESP-NET report.


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

                              ShortEncounter related to the public health eventContext of the Composition
                              Control10..1
                              TypeReference(US Public Health Encounter, Encounter)
                              Is Modifierfalse
                              Must Supporttrue
                              Summarytrue
                              Requirements

                              Provides context for the composition and supports searching.

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

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

                              ShortComposition editing time
                              Comments

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

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

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


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

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

                              It is possible to have multiple authors - especially in the case where the default author is the organization. Author information can contain the HDEA/BSA as a Device Author.


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

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

                              Identifies who is responsible for the content.

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

                              Official human-readable label for the composition.

                              ShortHuman Readable name/title
                              Comments

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

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

                              The root of the sections that make up the composition.

                              ShortComposition is broken into sections
                              Control0..*
                              TypeBackboneElement
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                              SlicingThis element introduces a set of slices on Composition.section. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ code
                              • 28. Composition.section.modifierExtension
                                Definition

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

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

                                ShortExtensions that cannot be ignored even if unrecognized
                                Comments

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

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

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

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

                                This section lists and describes all the patient's encounter information related to the encounter.


                                The root of the sections that make up the composition.

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

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

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

                                ShortExtensions that cannot be ignored even if unrecognized
                                Comments

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

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

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

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

                                Encounter Section code


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

                                ShortEncounter Section codeClassification of section (recommended)
                                Comments

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

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

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

                                Classification of a section of a composition/document.

                                TypeCodeableConcept
                                Is Modifierfalse
                                Must Supporttrue
                                Summaryfalse
                                Requirements

                                Provides computable standardized labels to topics within the document.

                                Pattern Value{
                                  "coding" : [{
                                    "system" : "http://loinc.org",
                                    "code" : "67781-5"
                                  }]
                                }
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                36. Composition.section:sliceEncounterSection.text
                                Definition

                                Encounter Section narrative


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

                                ShortEncounter Section narrativeText summary of the section, for human interpretation
                                Comments

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

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

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

                                ShortA reference to data that supports this section
                                Comments

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

                                Control0..*
                                This element is affected by the following invariants: cmp-2
                                TypeReference(Resource)
                                Is Modifierfalse
                                Must Supporttrue
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • profile @ resolve()
                                • 40. Composition.section:sliceEncounterSection.entry:sliceEncounter
                                  Slice NamesliceEncounter
                                  Definition

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

                                  ShortEncounter EntryA reference to data that supports this section
                                  Comments

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

                                  Control0..*
                                  This element is affected by the following invariants: cmp-2
                                  TypeReference(US Public Health Encounter, Resource)
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  42. Composition.section:sliceEncounterSection.entry:sliceEncounterDiagnosis
                                  Slice NamesliceEncounterDiagnosis
                                  Definition

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

                                  ShortEncounter Diagnosis EntryA reference to data that supports this section
                                  Comments

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

                                  Control0..*
                                  This element is affected by the following invariants: cmp-2
                                  TypeReference(US Core Condition Encounter Diagnosis Profile, Resource)
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  44. Composition.section:sliceProblemSection
                                  Slice NamesliceProblemSection
                                  Definition

                                  This section lists and describes all the patient's current problems on the maintained problem list.


                                  The root of the sections that make up the composition.

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

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

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

                                  ShortExtensions that cannot be ignored even if unrecognized
                                  Comments

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

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

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

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

                                  Problem Section code


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

                                  ShortProblem Section codeClassification of section (recommended)
                                  Comments

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

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

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

                                  Classification of a section of a composition/document.

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summaryfalse
                                  Requirements

                                  Provides computable standardized labels to topics within the document.

                                  Pattern Value{
                                    "coding" : [{
                                      "system" : "http://loinc.org",
                                      "code" : "11450-4"
                                    }]
                                  }
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  50. Composition.section:sliceProblemSection.text
                                  Definition

                                  Problem Section narrative


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

                                  ShortProblem Section narrativeText summary of the section, for human interpretation
                                  Comments

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

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

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

                                  ShortA reference to data that supports this section
                                  Comments

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

                                  Control0..*
                                  This element is affected by the following invariants: cmp-2
                                  TypeReference(Resource)
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • profile @ resolve()
                                  • 54. Composition.section:sliceProblemSection.entry:sliceCondition
                                    Slice NamesliceCondition
                                    Definition

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

                                    ShortCondition EntryA reference to data that supports this section
                                    Comments

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

                                    Control0..*
                                    This element is affected by the following invariants: cmp-2
                                    TypeReference(US Public Health Condition, Resource)
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    56. Composition.section:sliceProblemSection.entry:sliceProblemHealthConcern
                                    Slice NamesliceProblemHealthConcern
                                    Definition

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

                                    ShortProblem Health Concern EntryA reference to data that supports this section
                                    Comments

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

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

                                    The Medications Administered Section defines medications administered during the encounter.


                                    The root of the sections that make up the composition.

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

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

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

                                    ShortExtensions that cannot be ignored even if unrecognized
                                    Comments

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

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

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

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

                                    Medications Administered Section code


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

                                    ShortMedications Administered Section codeClassification of section (recommended)
                                    Comments

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

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

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

                                    Classification of a section of a composition/document.

                                    TypeCodeableConcept
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summaryfalse
                                    Requirements

                                    Provides computable standardized labels to topics within the document.

                                    Pattern Value{
                                      "coding" : [{
                                        "system" : "http://loinc.org",
                                        "code" : "29549-3"
                                      }]
                                    }
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    64. Composition.section:sliceMedicationsAdministeredSection.text
                                    Definition

                                    Medications Administered Section narrative


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

                                    ShortMedications Administered Section narrativeText summary of the section, for human interpretation
                                    Comments

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

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

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

                                    ShortA reference to data that supports this section
                                    Comments

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

                                    Control0..*
                                    This element is affected by the following invariants: cmp-2
                                    TypeReference(Resource)
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • profile @ resolve()
                                    • 68. Composition.section:sliceMedicationsAdministeredSection.entry:sliceMedicationAdministration
                                      Slice NamesliceMedicationAdministration
                                      Definition

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

                                      ShortMedication Administration EntryA reference to data that supports this section
                                      Comments

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

                                      Control0..*
                                      This element is affected by the following invariants: cmp-2
                                      TypeReference(US Public Health MedicationAdministration, Resource)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      70. Composition.section:sliceMedicationsAdministeredSection.entry:sliceMedicationReferences
                                      Slice NamesliceMedicationReferences
                                      Definition

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

                                      ShortMedication Reference EntryA reference to data that supports this section
                                      Comments

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

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

                                      The Medications Section contains a patient's current medications and pertinent medication history. At a minimum, the currently active medications are listed.


                                      The root of the sections that make up the composition.

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

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

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

                                      ShortExtensions that cannot be ignored even if unrecognized
                                      Comments

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

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

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

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

                                      Medications Section code


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

                                      ShortMedications Section codeClassification of section (recommended)
                                      Comments

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

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

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

                                      Classification of a section of a composition/document.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summaryfalse
                                      Requirements

                                      Provides computable standardized labels to topics within the document.

                                      Pattern Value{
                                        "coding" : [{
                                          "system" : "http://loinc.org",
                                          "code" : "10160-0"
                                        }]
                                      }
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      78. Composition.section:sliceMedicationsSection.text
                                      Definition

                                      Medications Section narrative


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

                                      ShortMedications Section narrativeText summary of the section, for human interpretation
                                      Comments

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

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

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

                                      ShortA reference to data that supports this section
                                      Comments

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

                                      Control0..*
                                      This element is affected by the following invariants: cmp-2
                                      TypeReference(Resource)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • profile @ resolve()
                                      • 82. Composition.section:sliceMedicationsSection.entry:sliceMedicationAdministration
                                        Slice NamesliceMedicationAdministration
                                        Definition

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

                                        ShortMedication Administration EntryA reference to data that supports this section
                                        Comments

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

                                        Control0..*
                                        This element is affected by the following invariants: cmp-2
                                        TypeReference(US Public Health MedicationAdministration, Resource)
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        84. Composition.section:sliceMedicationsSection.entry:sliceMedicationStatement
                                        Slice NamesliceMedicationStatement
                                        Definition

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

                                        ShortMedication Statement EntryA reference to data that supports this section
                                        Comments

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

                                        Control0..*
                                        This element is affected by the following invariants: cmp-2
                                        TypeReference(RESP-NET Medication Statement, Resource)
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        86. Composition.section:sliceMedicationsSection.entry:sliceMedicationReferences
                                        Slice NamesliceMedicationReferences
                                        Definition

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

                                        ShortMedication Reference EntryA reference to data that supports this section
                                        Comments

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

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

                                        The Results Section contains observations of results generated by laboratories, imaging procedures, and other procedures. The scope includes observations such as hematology, chemistry, serology, virology, toxicology, microbiology, plain x-ray, ultrasound, CT, MRI, angiography, echocardiography, nuclear medicine, pathology, and procedure observations. The section often includes notable results such as abnormal values or relevant trends, and could contain all results for the period of time being documented.

                                        Laboratory results are typically generated by laboratories providing analytic services in areas such as chemistry, hematology, serology, histology, cytology, anatomic pathology, microbiology, and/or virology. These observations are based on analysis of specimens obtained from the patient and submitted to the laboratory. Imaging results are typically generated by a clinician reviewing the output of an imaging procedure, such as where a cardiologist reports the left ventricular ejection fraction based on the review of a cardiac echocardiogram.

                                        Procedure results are typically generated by a clinician to provide more granular information about component observations made during a procedure, such as where a gastroenterologist reports the size of a polyp observed during a colonoscopy.


                                        The root of the sections that make up the composition.

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

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

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

                                        ShortExtensions that cannot be ignored even if unrecognized
                                        Comments

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

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

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

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

                                        Results Section code


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

                                        ShortResults Section codeClassification of section (recommended)
                                        Comments

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

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

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

                                        Classification of a section of a composition/document.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summaryfalse
                                        Requirements

                                        Provides computable standardized labels to topics within the document.

                                        Pattern Value{
                                          "coding" : [{
                                            "system" : "http://loinc.org",
                                            "code" : "30954-2"
                                          }]
                                        }
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        94. Composition.section:sliceResultsSection.text
                                        Definition

                                        Results Section narrative


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

                                        ShortResults Section narrativeText summary of the section, for human interpretation
                                        Comments

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

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

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

                                        ShortA reference to data that supports this section
                                        Comments

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

                                        Control0..*
                                        This element is affected by the following invariants: cmp-2
                                        TypeReference(Resource)
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • profile @ resolve()
                                        • 98. Composition.section:sliceResultsSection.entry:observationEntries
                                          Slice NameobservationEntries
                                          Definition

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

                                          ShortObservation EntriesA reference to data that supports this section
                                          Comments

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

                                          Control0..*
                                          This element is affected by the following invariants: cmp-2
                                          TypeReference(US Public Health Laboratory Result Observation Profile, US Core Observation Clinical Result Profile, US Core Simple Observation Profile, Resource)
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Must Support TypesNo must-support rules about the choice of types/profiles
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          100. Composition.section:sliceResultsSection.entry:sliceDiagnosticResultEntry
                                          Slice NamesliceDiagnosticResultEntry
                                          Definition

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

                                          ShortDiagnostic Result EntryA reference to data that supports this section
                                          Comments

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

                                          Control0..*
                                          This element is affected by the following invariants: cmp-2
                                          TypeReference(US Core DiagnosticReport Profile for Laboratory Results Reporting, Resource)
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          102. Composition.section:sliceNotesSection
                                          Slice NamesliceNotesSection
                                          Definition

                                          The Notes Section contains clinical notes and diagnostic reports.


                                          The root of the sections that make up the composition.

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

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

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

                                          ShortExtensions that cannot be ignored even if unrecognized
                                          Comments

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

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

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

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

                                          Clinical Notes Section code


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

                                          ShortClinical Notes Section codeClassification of section (recommended)
                                          Comments

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

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

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

                                          Classification of a section of a composition/document.

                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Summaryfalse
                                          Requirements

                                          Provides computable standardized labels to topics within the document.

                                          Pattern Value{
                                            "coding" : [{
                                              "system" : "http://loinc.org",
                                              "code" : "28650-0"
                                            }]
                                          }
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          108. Composition.section:sliceNotesSection.text
                                          Definition

                                          Notes Section narrative


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

                                          ShortNotes Section narrativeText summary of the section, for human interpretation
                                          Comments

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

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

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

                                          ShortA reference to data that supports this section
                                          Comments

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

                                          Control0..*
                                          This element is affected by the following invariants: cmp-2
                                          TypeReference(Resource)
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • profile @ resolve()
                                          • 112. Composition.section:sliceNotesSection.entry:sliceDocumentReferenceEntry
                                            Slice NamesliceDocumentReferenceEntry
                                            Definition

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

                                            ShortDocument Reference EntryA reference to data that supports this section
                                            Comments

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

                                            Control0..*
                                            This element is affected by the following invariants: cmp-2
                                            TypeReference(US Core DocumentReference Profile, Resource)
                                            Is Modifierfalse
                                            Must Supporttrue
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            114. Composition.section:sliceNotesSection.entry:sliceDiagnosticReportEntry
                                            Slice NamesliceDiagnosticReportEntry
                                            Definition

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

                                            ShortDiagnostic Report EntryA reference to data that supports this section
                                            Comments

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

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

                                            This section, contains data that define pending orders, interventions, encounters, services, and procedures for the patient. It is limited to prospective, unfulfilled, or incomplete orders and requests only. All active, incomplete, or pending orders, appointments, referrals, procedures, services, or any other pending event of clinical significance to the current care of the patient should be listed.


                                            The root of the sections that make up the composition.

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

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

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

                                            ShortExtensions that cannot be ignored even if unrecognized
                                            Comments

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

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

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

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

                                            Plan of Treatment code


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

                                            ShortPlan of Treatment codeClassification of section (recommended)
                                            Comments

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

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

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

                                            Classification of a section of a composition/document.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Must Supporttrue
                                            Summaryfalse
                                            Requirements

                                            Provides computable standardized labels to topics within the document.

                                            Pattern Value{
                                              "coding" : [{
                                                "system" : "http://loinc.org",
                                                "code" : "18776-5"
                                              }]
                                            }
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            122. Composition.section:slicePlanOfTreatmentSection.text
                                            Definition

                                            Plan of Treatment narrative


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

                                            ShortPlan of Treatment narrativeText summary of the section, for human interpretation
                                            Comments

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

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

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

                                            ShortA reference to data that supports this section
                                            Comments

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

                                            Control0..*
                                            This element is affected by the following invariants: cmp-2
                                            TypeReference(Resource)
                                            Is Modifierfalse
                                            Must Supporttrue
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • profile @ resolve()
                                            • 126. Composition.section:slicePlanOfTreatmentSection.entry:sliceServiceRequests
                                              Slice NamesliceServiceRequests
                                              Definition

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

                                              ShortService Request EntryA reference to data that supports this section
                                              Comments

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

                                              Control0..*
                                              This element is affected by the following invariants: cmp-2
                                              TypeReference(eICR ServiceRequest, US Core ServiceRequest Profile, Resource)
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Must Support TypesNo must-support rules about the choice of types/profiles
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              128. Composition.section:slicePlanOfTreatmentSection.entry:sliceMedicationRequest
                                              Slice NamesliceMedicationRequest
                                              Definition

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

                                              ShortMedication Request EntryA reference to data that supports this section
                                              Comments

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

                                              Control0..*
                                              This element is affected by the following invariants: cmp-2
                                              TypeReference(US Core MedicationRequest Profile, Resource)
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              130. Composition.section:slicePlanOfTreatmentSection.entry:sliceMedicationReferences
                                              Slice NamesliceMedicationReferences
                                              Definition

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

                                              ShortMedication Reference EntryA reference to data that supports this section
                                              Comments

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

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

                                              The Immunizations Section defines a patient's current immunization status and pertinent immunization history. The primary use case for the Immunization Section is to enable communication of a patient's immunization status. The section should include current immunization status, and may contain the entire immunization history that is relevant to the period of time being summarized.


                                              The root of the sections that make up the composition.

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

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

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

                                              ShortExtensions that cannot be ignored even if unrecognized
                                              Comments

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

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

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

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

                                              Immunizations code


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

                                              ShortImmunizations codeClassification of section (recommended)
                                              Comments

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

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

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

                                              Classification of a section of a composition/document.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              Requirements

                                              Provides computable standardized labels to topics within the document.

                                              Pattern Value{
                                                "coding" : [{
                                                  "system" : "http://loinc.org",
                                                  "code" : "11369-6"
                                                }]
                                              }
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              138. Composition.section:sliceImmunizationsSection.text
                                              Definition

                                              Immunizations narrative


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

                                              ShortImmunizations narrativeText summary of the section, for human interpretation
                                              Comments

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

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

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

                                              ShortA reference to data that supports this section
                                              Comments

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

                                              Control0..*
                                              This element is affected by the following invariants: cmp-2
                                              TypeReference(Resource)
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • profile @ resolve()
                                              • 142. Composition.section:sliceImmunizationsSection.entry:sliceImmunizations
                                                Slice NamesliceImmunizations
                                                Definition

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

                                                ShortImmunizations EntryA reference to data that supports this section
                                                Comments

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

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

                                                This section describes all interventional, surgical, diagnostic, or therapeutic procedures or treatments pertinent to the patient historically at the time the document is generated. The section should include notable procedures, but can contain all procedures for the period of time being summarized.


                                                The root of the sections that make up the composition.

                                                ShortThis section describes all interventional, surgical, diagnostic, or therapeutic procedures or treatments pertinent to the patient historically at the time the document is generated.Composition is broken into sections
                                                Control0..1*
                                                TypeBackboneElement
                                                Is Modifierfalse
                                                Must Supporttrue
                                                Summaryfalse
                                                Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                146. Composition.section:sliceProceduresSection.modifierExtension
                                                Definition

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

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

                                                ShortExtensions that cannot be ignored even if unrecognized
                                                Comments

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

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

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

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

                                                Procedures Section code


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

                                                ShortProcedures Section codeClassification of section (recommended)
                                                Comments

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

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

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

                                                Classification of a section of a composition/document.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supporttrue
                                                Summaryfalse
                                                Requirements

                                                Provides computable standardized labels to topics within the document.

                                                Pattern Value{
                                                  "coding" : [{
                                                    "system" : "http://loinc.org",
                                                    "code" : "47519-4"
                                                  }]
                                                }
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                150. Composition.section:sliceProceduresSection.text
                                                Definition

                                                Procedures Section narrative


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

                                                ShortProcedures Section narrativeText summary of the section, for human interpretation
                                                Comments

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

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

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

                                                ShortA reference to data that supports this section
                                                Comments

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

                                                Control0..*
                                                This element is affected by the following invariants: cmp-2
                                                TypeReference(Resource)
                                                Is Modifierfalse
                                                Must Supporttrue
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • profile @ resolve()
                                                • 154. Composition.section:sliceProceduresSection.entry:sliceProcedures
                                                  Slice NamesliceProcedures
                                                  Definition

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

                                                  ShortProcedures EntryA reference to data that supports this section
                                                  Comments

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

                                                  Control0..*
                                                  This element is affected by the following invariants: cmp-2
                                                  TypeReference(eICR Procedure, Resource)
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  156. Composition.section:sliceVitalSignsSection
                                                  Slice NamesliceVitalSignsSection
                                                  Definition

                                                  The Vital Signs Section contains relevant vital signs for the eICR. The section should include notable vital signs such as the most recent, maximum and/or minimum, baseline, or relevant trends. Vital signs are represented in the same way as other results, but are aggregated into their own section to follow clinical conventions.


                                                  The root of the sections that make up the composition.

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

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

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

                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                  Comments

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

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

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

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

                                                  Vital Signs code


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

                                                  ShortVital Signs codeClassification of section (recommended)
                                                  Comments

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

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

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

                                                  Classification of a section of a composition/document.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  Requirements

                                                  Provides computable standardized labels to topics within the document.

                                                  Pattern Value{
                                                    "coding" : [{
                                                      "system" : "http://loinc.org",
                                                      "code" : "8716-3"
                                                    }]
                                                  }
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  162. Composition.section:sliceVitalSignsSection.text
                                                  Definition

                                                  Vital Signs narrative


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

                                                  ShortVital Signs narrativeText summary of the section, for human interpretation
                                                  Comments

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

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

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

                                                  ShortA reference to data that supports this section
                                                  Comments

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

                                                  Control0..*
                                                  This element is affected by the following invariants: cmp-2
                                                  TypeReference(Resource)
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • profile @ resolve()
                                                  • 166. Composition.section:sliceVitalSignsSection.entry:sliceVitalSigns
                                                    Slice NamesliceVitalSigns
                                                    Definition

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

                                                    ShortVital Signs EntryA reference to data that supports this section
                                                    Comments

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

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

                                                    This section contains social history data that influence a patient’s physical, psychological or emotional health such as occupation, home environment, travel history, and disability status.


                                                    The root of the sections that make up the composition.

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

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

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

                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                    Comments

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

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

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

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

                                                    Social History Section code


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

                                                    ShortSocial History Section codeClassification of section (recommended)
                                                    Comments

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

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

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

                                                    Classification of a section of a composition/document.

                                                    TypeCodeableConcept
                                                    Is Modifierfalse
                                                    Must Supporttrue
                                                    Summaryfalse
                                                    Requirements

                                                    Provides computable standardized labels to topics within the document.

                                                    Pattern Value{
                                                      "coding" : [{
                                                        "system" : "http://loinc.org",
                                                        "code" : "29762-2"
                                                      }]
                                                    }
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    174. Composition.section:sliceSocialHistorySection.text
                                                    Definition

                                                    Social History Section narrative


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

                                                    ShortSocial History Section narrativeText summary of the section, for human interpretation
                                                    Comments

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

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

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

                                                    ShortA reference to data that supports this section
                                                    Comments

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

                                                    Control0..*
                                                    This element is affected by the following invariants: cmp-2
                                                    TypeReference(Resource)
                                                    Is Modifierfalse
                                                    Must Supporttrue
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • profile @ resolve()
                                                    • 178. Composition.section:sliceSocialHistorySection.entry:sliceSocialHistoryObservations
                                                      Slice NamesliceSocialHistoryObservations
                                                      Definition

                                                      Social History Observation entries


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

                                                      ShortSocial History ObservationsA reference to data that supports this section
                                                      Comments

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

                                                      Control0..*
                                                      This element is affected by the following invariants: cmp-2
                                                      TypeReference(US Core Smoking Status Observation Profile, US Public Health Disability Status, US Core Simple Observation Profile, US Public Health Characteristics of Home Environment, Resource)
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Must Support TypesNo must-support rules about the choice of types/profiles
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      180. Composition.section:slicePregnancySection
                                                      Slice NameslicePregnancySection
                                                      Definition

                                                      This section contains pregnancy data


                                                      The root of the sections that make up the composition.

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

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

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

                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                      Comments

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

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

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

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

                                                      Pregnancy Section code


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

                                                      ShortPregnancy Section codeClassification of section (recommended)
                                                      Comments

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

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

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

                                                      Classification of a section of a composition/document.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Summaryfalse
                                                      Requirements

                                                      Provides computable standardized labels to topics within the document.

                                                      Pattern Value{
                                                        "coding" : [{
                                                          "system" : "http://loinc.org",
                                                          "code" : "90767-5"
                                                        }]
                                                      }
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      186. Composition.section:slicePregnancySection.text
                                                      Definition

                                                      Pregnancy Section narrative


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

                                                      ShortPregnancy Section narrativeText summary of the section, for human interpretation
                                                      Comments

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

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

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

                                                      ShortA reference to data that supports this section
                                                      Comments

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

                                                      Control0..*
                                                      This element is affected by the following invariants: cmp-2
                                                      TypeReference(Resource)
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                      • profile @ resolve()
                                                      • 190. Composition.section:slicePregnancySection.entry:slicePregnancyOutcome
                                                        Slice NameslicePregnancyOutcome
                                                        Definition

                                                        Pregnancy Outcome entry


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

                                                        ShortPregnancy OutcomeA reference to data that supports this section
                                                        Comments

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

                                                        Control0..*
                                                        This element is affected by the following invariants: cmp-2
                                                        TypeReference(US Public Health Pregnancy Outcome Observation, Resource)
                                                        Is Modifierfalse
                                                        Must Supporttrue
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        192. Composition.section:slicePregnancySection.entry:slicePregnancyStatusObservation
                                                        Slice NameslicePregnancyStatusObservation
                                                        Definition

                                                        Pregnancy Status Observation Entry


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

                                                        ShortPregnancy Status ObservationA reference to data that supports this section
                                                        Comments

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

                                                        Control0..*
                                                        This element is affected by the following invariants: cmp-2
                                                        TypeReference(US Core Observation Pregnancy Status Profile, Resource)
                                                        Is Modifierfalse
                                                        Must Supporttrue
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        194. Composition.section:slicePregnancySection.entry:slicePostpartumStatus
                                                        Slice NameslicePostpartumStatus
                                                        Definition

                                                        Postpartum Status Entry


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

                                                        ShortPostpartum StatusA reference to data that supports this section
                                                        Comments

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

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

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

                                                        0. Composition
                                                        Definition

                                                        The RESP-NET Composition profile establishes the core elements, extensions, vocabularies and value sets for representing RESP-NET report.

                                                        ShortResp-net Composition Profile
                                                        Comments

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

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

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

                                                        ShortLogical id of this artifact
                                                        Comments

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

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

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

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

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

                                                        ShortA set of rules under which this content was created
                                                        Comments

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

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

                                                        The base language in which the resource is written.

                                                        ShortLanguage of the resource content
                                                        Comments

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

                                                        Control0..1
                                                        BindingThe codes SHOULD be taken from CommonLanguages
                                                        (preferred to http://hl7.org/fhir/ValueSet/languages)

                                                        A human language.

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

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

                                                        ShortText summary of the resource, for human interpretation
                                                        Comments

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

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

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

                                                        ShortContained, inline Resources
                                                        Comments

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

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

                                                        An Extension

                                                        ShortExtension
                                                        Control1..*
                                                        TypeExtension
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        SlicingThis element introduces a set of slices on Composition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                        • value @ url
                                                        • 16. Composition.extension:respnet-report-context
                                                          Slice Namerespnet-report-context
                                                          Definition

                                                          Indicates the RESP-NET report context

                                                          ShortIndicates the RESP-NET report context
                                                          Control1..1
                                                          This element is affected by the following invariants: ele-1
                                                          TypeExtension(RESP-NET Report Context Extension) (Extension Type: CodeableConcept)
                                                          Is Modifierfalse
                                                          Must Supporttrue
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          18. Composition.modifierExtension
                                                          Definition

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

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

                                                          ShortExtensions that cannot be ignored
                                                          Comments

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

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

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

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

                                                          RESP-NET Composition identifier. This is equivalent to ClinicalDocument.setId in CDA. The identifier of the containing Bundle is equivalent to ClinicalDocument.id in CDA.

                                                          ShortRESP-NET Composition identifier
                                                          Comments

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

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

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

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

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

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

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

                                                          The workflow/clinical status of the composition.

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

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

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

                                                          The type of this Composition is a RESP-NET Report

                                                          ShortRESP-NET Report
                                                          Comments

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

                                                          Control1..1
                                                          BindingThe codes SHOULD be taken from FHIRDocumentTypeCodes
                                                          (preferred to http://hl7.org/fhir/ValueSet/doc-typecodes)

                                                          Type of a composition.

                                                          TypeCodeableConcept
                                                          Is Modifierfalse
                                                          Must Supporttrue
                                                          Summarytrue
                                                          Requirements

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

                                                          Pattern Value{
                                                            "coding" : [{
                                                              "system" : "http://loinc.org",
                                                              "code" : "55751-2"
                                                            }]
                                                          }
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          26. Composition.category
                                                          Definition

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

                                                          ShortCategorization of Composition
                                                          Comments

                                                          This is a metadata field from XDS/MHD.

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

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

                                                          TypeCodeableConcept
                                                          Is Modifierfalse
                                                          Summarytrue
                                                          Requirements

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

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

                                                          This Patient profile represents the subject of the RESP-NET report.

                                                          ShortPatient who is the subject of the report.
                                                          Comments

                                                          For clinical documents, this is usually the patient.

                                                          Control1..1
                                                          TypeReference(US Public Health Patient)
                                                          Is Modifierfalse
                                                          Must Supporttrue
                                                          Summarytrue
                                                          Requirements

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

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

                                                          This Encounter profile represents the encounter related to the RESP-NET report.

                                                          ShortEncounter related to the public health event
                                                          Control1..1
                                                          TypeReference(US Public Health Encounter)
                                                          Is Modifierfalse
                                                          Must Supporttrue
                                                          Summarytrue
                                                          Requirements

                                                          Provides context for the composition and supports searching.

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

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

                                                          ShortComposition editing time
                                                          Comments

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

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

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

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

                                                          It is possible to have multiple authors - especially in the case where the default author is the organization. Author information can contain the HDEA/BSA as a Device Author.

                                                          ShortThe author(s) of the document
                                                          Control1..*
                                                          TypeReference(US Core PractitionerRole Profile, US Core Practitioner Profile, US Core Organization Profile, Device)
                                                          Is Modifierfalse
                                                          Must Supporttrue
                                                          Must Support TypesNo must-support rules about the choice of types/profiles
                                                          Summarytrue
                                                          Requirements

                                                          Identifies who is responsible for the content.

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

                                                          Official human-readable label for the composition.

                                                          ShortHuman Readable name/title
                                                          Comments

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

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

                                                          The code specifying the level of confidentiality of the Composition.

                                                          ShortAs defined by affinity domain
                                                          Comments

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

                                                          Control0..1
                                                          BindingThe codes SHALL be taken from v3.ConfidentialityClassification (2014-03-26)
                                                          (required to http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26)

                                                          Codes specifying the level of confidentiality of the composition.

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

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

                                                          ShortAttests to accuracy of composition
                                                          Comments

                                                          Only list each attester once.

                                                          Control0..*
                                                          TypeBackboneElement
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Requirements

                                                          Identifies responsibility for the accuracy of the composition content.

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

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

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

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

                                                          ShortAdditional content defined by implementations
                                                          Comments

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

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

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

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

                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                          Comments

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

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

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

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

                                                          The type of attestation the authenticator offers.

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

                                                          The way in which a person authenticated a composition.

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

                                                          Indicates the level of authority of the attestation.

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

                                                          When the composition was attested by the party.

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

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

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

                                                          Who attested the composition in the specified way.

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

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

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

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

                                                          ShortOrganization which maintains the composition
                                                          Comments

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

                                                          Control0..1
                                                          TypeReference(Organization)
                                                          Is Modifierfalse
                                                          Summarytrue
                                                          Requirements

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

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

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

                                                          ShortRelationships to other compositions/documents
                                                          Comments

                                                          A document is a version specific composition.

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

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

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

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

                                                          ShortAdditional content defined by implementations
                                                          Comments

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

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

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

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

                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                          Comments

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

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

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

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

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

                                                          Shortreplaces | transforms | signs | appends
                                                          Comments

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

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

                                                          The type of relationship between documents.

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

                                                          The target composition/document of this relationship.

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

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

                                                          ShortThe clinical service(s) being documented
                                                          Comments

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

                                                          Control0..*
                                                          TypeBackboneElement
                                                          Is Modifierfalse
                                                          Summarytrue
                                                          Requirements

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

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

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

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

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

                                                          ShortAdditional content defined by implementations
                                                          Comments

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

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

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

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

                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                          Comments

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

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

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

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

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

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

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

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

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

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

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

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

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

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

                                                          The root of the sections that make up the composition.

                                                          ShortComposition is broken into sections
                                                          Control0..*
                                                          TypeBackboneElement
                                                          Is Modifierfalse
                                                          Must Supporttrue
                                                          Summaryfalse
                                                          Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          SlicingThis element introduces a set of slices on Composition.section. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                          • value @ code
                                                          • 84. Composition.section.id
                                                            Definition

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

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

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

                                                            ShortAdditional content defined by implementations
                                                            Comments

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

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

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

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

                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                            Comments

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

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

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

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

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

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

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

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

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

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

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

                                                            ShortClassification of section (recommended)
                                                            Comments

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

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

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

                                                            Classification of a section of a composition/document.

                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Provides computable standardized labels to topics within the document.

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

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

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

                                                            Identifies who is responsible for the content.

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

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

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

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

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

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

                                                            ShortText summary of the section, for human interpretation
                                                            Comments

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

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

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

                                                            Shortworking | snapshot | changes
                                                            Comments

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

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

                                                            The processing mode that applies to this section.

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

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

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

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

                                                            ShortOrder of section entries
                                                            Comments

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

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

                                                            What order applies to the items in the entry.

                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Requirements

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

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

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

                                                            ShortA reference to data that supports this section
                                                            Comments

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

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

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

                                                            ShortWhy the section is empty
                                                            Comments

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

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

                                                            If a section is empty, why it is empty.

                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Requirements

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

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

                                                            A nested sub-section within this section.

                                                            ShortNested Section
                                                            Comments

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

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

                                                            This section lists and describes all the patient's encounter information related to the encounter.

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

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

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

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

                                                            ShortAdditional content defined by implementations
                                                            Comments

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

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

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

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

                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                            Comments

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

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

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

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

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

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

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

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

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

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

                                                            Encounter Section code

                                                            ShortEncounter Section code
                                                            Comments

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

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

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

                                                            Classification of a section of a composition/document.

                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Must Supporttrue
                                                            Summaryfalse
                                                            Requirements

                                                            Provides computable standardized labels to topics within the document.

                                                            Pattern Value{
                                                              "coding" : [{
                                                                "system" : "http://loinc.org",
                                                                "code" : "67781-5"
                                                              }]
                                                            }
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            122. Composition.section:sliceEncounterSection.author
                                                            Definition

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

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

                                                            Identifies who is responsible for the content.

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

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

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

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

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

                                                            Encounter Section narrative

                                                            ShortEncounter Section narrative
                                                            Comments

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

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

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

                                                            Shortworking | snapshot | changes
                                                            Comments

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

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

                                                            The processing mode that applies to this section.

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

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

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

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

                                                            ShortOrder of section entries
                                                            Comments

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

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

                                                            What order applies to the items in the entry.

                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Requirements

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

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

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

                                                            ShortA reference to data that supports this section
                                                            Comments

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

                                                            Control0..*
                                                            This element is affected by the following invariants: cmp-2
                                                            TypeReference(Resource)
                                                            Is Modifierfalse
                                                            Must Supporttrue
                                                            Summaryfalse
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                            • profile @ resolve()
                                                            • 134. Composition.section:sliceEncounterSection.entry:sliceEncounter
                                                              Slice NamesliceEncounter
                                                              Definition

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

                                                              ShortEncounter Entry
                                                              Comments

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

                                                              Control0..*
                                                              This element is affected by the following invariants: cmp-2
                                                              TypeReference(US Public Health Encounter)
                                                              Is Modifierfalse
                                                              Must Supporttrue
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              136. Composition.section:sliceEncounterSection.entry:sliceEncounterDiagnosis
                                                              Slice NamesliceEncounterDiagnosis
                                                              Definition

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

                                                              ShortEncounter Diagnosis Entry
                                                              Comments

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

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

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

                                                              ShortWhy the section is empty
                                                              Comments

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

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

                                                              If a section is empty, why it is empty.

                                                              TypeCodeableConcept
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Requirements

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

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

                                                              A nested sub-section within this section.

                                                              ShortNested Section
                                                              Comments

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

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

                                                              This section lists and describes all the patient's current problems on the maintained problem list.

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

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

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

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

                                                              ShortAdditional content defined by implementations
                                                              Comments

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

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

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

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

                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                              Comments

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

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

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

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

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

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

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

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

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

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

                                                              Problem Section code

                                                              ShortProblem Section code
                                                              Comments

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

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

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

                                                              Classification of a section of a composition/document.

                                                              TypeCodeableConcept
                                                              Is Modifierfalse
                                                              Must Supporttrue
                                                              Summaryfalse
                                                              Requirements

                                                              Provides computable standardized labels to topics within the document.

                                                              Pattern Value{
                                                                "coding" : [{
                                                                  "system" : "http://loinc.org",
                                                                  "code" : "11450-4"
                                                                }]
                                                              }
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              154. Composition.section:sliceProblemSection.author
                                                              Definition

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

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

                                                              Identifies who is responsible for the content.

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

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

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

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

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

                                                              Problem Section narrative

                                                              ShortProblem Section narrative
                                                              Comments

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

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

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

                                                              Shortworking | snapshot | changes
                                                              Comments

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

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

                                                              The processing mode that applies to this section.

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

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

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

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

                                                              ShortOrder of section entries
                                                              Comments

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

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

                                                              What order applies to the items in the entry.

                                                              TypeCodeableConcept
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Requirements

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

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

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

                                                              ShortA reference to data that supports this section
                                                              Comments

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

                                                              Control0..*
                                                              This element is affected by the following invariants: cmp-2
                                                              TypeReference(Resource)
                                                              Is Modifierfalse
                                                              Must Supporttrue
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                              • profile @ resolve()
                                                              • 166. Composition.section:sliceProblemSection.entry:sliceCondition
                                                                Slice NamesliceCondition
                                                                Definition

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

                                                                ShortCondition Entry
                                                                Comments

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

                                                                Control0..*
                                                                This element is affected by the following invariants: cmp-2
                                                                TypeReference(US Public Health Condition)
                                                                Is Modifierfalse
                                                                Must Supporttrue
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                168. Composition.section:sliceProblemSection.entry:sliceProblemHealthConcern
                                                                Slice NamesliceProblemHealthConcern
                                                                Definition

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

                                                                ShortProblem Health Concern Entry
                                                                Comments

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

                                                                Control0..*
                                                                This element is affected by the following invariants: cmp-2
                                                                TypeReference(US Core Condition Problems and Health Concerns Profile)
                                                                Is Modifierfalse
                                                                Must Supporttrue
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                170. Composition.section:sliceProblemSection.emptyReason
                                                                Definition

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

                                                                ShortWhy the section is empty
                                                                Comments

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

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

                                                                If a section is empty, why it is empty.

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

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

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

                                                                A nested sub-section within this section.

                                                                ShortNested Section
                                                                Comments

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

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

                                                                The Medications Administered Section defines medications administered during the encounter.

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

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

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

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

                                                                ShortAdditional content defined by implementations
                                                                Comments

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

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

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

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

                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                Comments

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

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

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

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

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

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

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

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

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

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

                                                                Medications Administered Section code

                                                                ShortMedications Administered Section code
                                                                Comments

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

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

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

                                                                Classification of a section of a composition/document.

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Must Supporttrue
                                                                Summaryfalse
                                                                Requirements

                                                                Provides computable standardized labels to topics within the document.

                                                                Pattern Value{
                                                                  "coding" : [{
                                                                    "system" : "http://loinc.org",
                                                                    "code" : "29549-3"
                                                                  }]
                                                                }
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                186. Composition.section:sliceMedicationsAdministeredSection.author
                                                                Definition

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

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

                                                                Identifies who is responsible for the content.

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

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

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

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

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

                                                                Medications Administered Section narrative

                                                                ShortMedications Administered Section narrative
                                                                Comments

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

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

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

                                                                Shortworking | snapshot | changes
                                                                Comments

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

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

                                                                The processing mode that applies to this section.

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

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

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

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

                                                                ShortOrder of section entries
                                                                Comments

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

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

                                                                What order applies to the items in the entry.

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

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

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

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

                                                                ShortA reference to data that supports this section
                                                                Comments

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

                                                                Control0..*
                                                                This element is affected by the following invariants: cmp-2
                                                                TypeReference(Resource)
                                                                Is Modifierfalse
                                                                Must Supporttrue
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                • profile @ resolve()
                                                                • 198. Composition.section:sliceMedicationsAdministeredSection.entry:sliceMedicationAdministration
                                                                  Slice NamesliceMedicationAdministration
                                                                  Definition

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

                                                                  ShortMedication Administration Entry
                                                                  Comments

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

                                                                  Control0..*
                                                                  This element is affected by the following invariants: cmp-2
                                                                  TypeReference(US Public Health MedicationAdministration)
                                                                  Is Modifierfalse
                                                                  Must Supporttrue
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  200. Composition.section:sliceMedicationsAdministeredSection.entry:sliceMedicationReferences
                                                                  Slice NamesliceMedicationReferences
                                                                  Definition

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

                                                                  ShortMedication Reference Entry
                                                                  Comments

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

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

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

                                                                  ShortWhy the section is empty
                                                                  Comments

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

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

                                                                  If a section is empty, why it is empty.

                                                                  TypeCodeableConcept
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Requirements

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

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

                                                                  A nested sub-section within this section.

                                                                  ShortNested Section
                                                                  Comments

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

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

                                                                  The Medications Section contains a patient's current medications and pertinent medication history. At a minimum, the currently active medications are listed.

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

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

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

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

                                                                  ShortAdditional content defined by implementations
                                                                  Comments

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

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

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

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

                                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                                  Comments

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

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

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

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

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

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

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

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

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

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

                                                                  Medications Section code

                                                                  ShortMedications Section code
                                                                  Comments

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

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

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

                                                                  Classification of a section of a composition/document.

                                                                  TypeCodeableConcept
                                                                  Is Modifierfalse
                                                                  Must Supporttrue
                                                                  Summaryfalse
                                                                  Requirements

                                                                  Provides computable standardized labels to topics within the document.

                                                                  Pattern Value{
                                                                    "coding" : [{
                                                                      "system" : "http://loinc.org",
                                                                      "code" : "10160-0"
                                                                    }]
                                                                  }
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  218. Composition.section:sliceMedicationsSection.author
                                                                  Definition

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

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

                                                                  Identifies who is responsible for the content.

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

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

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

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

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

                                                                  Medications Section narrative

                                                                  ShortMedications Section narrative
                                                                  Comments

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

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

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

                                                                  Shortworking | snapshot | changes
                                                                  Comments

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

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

                                                                  The processing mode that applies to this section.

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

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

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

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

                                                                  ShortOrder of section entries
                                                                  Comments

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

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

                                                                  What order applies to the items in the entry.

                                                                  TypeCodeableConcept
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Requirements

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

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

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

                                                                  ShortA reference to data that supports this section
                                                                  Comments

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

                                                                  Control0..*
                                                                  This element is affected by the following invariants: cmp-2
                                                                  TypeReference(Resource)
                                                                  Is Modifierfalse
                                                                  Must Supporttrue
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                  • profile @ resolve()
                                                                  • 230. Composition.section:sliceMedicationsSection.entry:sliceMedicationAdministration
                                                                    Slice NamesliceMedicationAdministration
                                                                    Definition

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

                                                                    ShortMedication Administration Entry
                                                                    Comments

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

                                                                    Control0..*
                                                                    This element is affected by the following invariants: cmp-2
                                                                    TypeReference(US Public Health MedicationAdministration)
                                                                    Is Modifierfalse
                                                                    Must Supporttrue
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    232. Composition.section:sliceMedicationsSection.entry:sliceMedicationStatement
                                                                    Slice NamesliceMedicationStatement
                                                                    Definition

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

                                                                    ShortMedication Statement Entry
                                                                    Comments

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

                                                                    Control0..*
                                                                    This element is affected by the following invariants: cmp-2
                                                                    TypeReference(RESP-NET Medication Statement)
                                                                    Is Modifierfalse
                                                                    Must Supporttrue
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    234. Composition.section:sliceMedicationsSection.entry:sliceMedicationReferences
                                                                    Slice NamesliceMedicationReferences
                                                                    Definition

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

                                                                    ShortMedication Reference Entry
                                                                    Comments

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

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

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

                                                                    ShortWhy the section is empty
                                                                    Comments

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

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

                                                                    If a section is empty, why it is empty.

                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Requirements

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

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

                                                                    A nested sub-section within this section.

                                                                    ShortNested Section
                                                                    Comments

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

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

                                                                    The Results Section contains observations of results generated by laboratories, imaging procedures, and other procedures. The scope includes observations such as hematology, chemistry, serology, virology, toxicology, microbiology, plain x-ray, ultrasound, CT, MRI, angiography, echocardiography, nuclear medicine, pathology, and procedure observations. The section often includes notable results such as abnormal values or relevant trends, and could contain all results for the period of time being documented.

                                                                    Laboratory results are typically generated by laboratories providing analytic services in areas such as chemistry, hematology, serology, histology, cytology, anatomic pathology, microbiology, and/or virology. These observations are based on analysis of specimens obtained from the patient and submitted to the laboratory. Imaging results are typically generated by a clinician reviewing the output of an imaging procedure, such as where a cardiologist reports the left ventricular ejection fraction based on the review of a cardiac echocardiogram.

                                                                    Procedure results are typically generated by a clinician to provide more granular information about component observations made during a procedure, such as where a gastroenterologist reports the size of a polyp observed during a colonoscopy.

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

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

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

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

                                                                    ShortAdditional content defined by implementations
                                                                    Comments

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

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

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

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

                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                    Comments

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

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

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

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

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

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

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

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

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

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

                                                                    Results Section code

                                                                    ShortResults Section code
                                                                    Comments

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

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

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

                                                                    Classification of a section of a composition/document.

                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Must Supporttrue
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Provides computable standardized labels to topics within the document.

                                                                    Pattern Value{
                                                                      "coding" : [{
                                                                        "system" : "http://loinc.org",
                                                                        "code" : "30954-2"
                                                                      }]
                                                                    }
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    252. Composition.section:sliceResultsSection.author
                                                                    Definition

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

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

                                                                    Identifies who is responsible for the content.

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

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

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

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

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

                                                                    Results Section narrative

                                                                    ShortResults Section narrative
                                                                    Comments

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

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

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

                                                                    Shortworking | snapshot | changes
                                                                    Comments

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

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

                                                                    The processing mode that applies to this section.

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

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

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

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

                                                                    ShortOrder of section entries
                                                                    Comments

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

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

                                                                    What order applies to the items in the entry.

                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Requirements

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

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

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

                                                                    ShortA reference to data that supports this section
                                                                    Comments

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

                                                                    Control0..*
                                                                    This element is affected by the following invariants: cmp-2
                                                                    TypeReference(Resource)
                                                                    Is Modifierfalse
                                                                    Must Supporttrue
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                    • profile @ resolve()
                                                                    • 264. Composition.section:sliceResultsSection.entry:observationEntries
                                                                      Slice NameobservationEntries
                                                                      Definition

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

                                                                      ShortObservation Entries
                                                                      Comments

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

                                                                      Control0..*
                                                                      This element is affected by the following invariants: cmp-2
                                                                      TypeReference(US Public Health Laboratory Result Observation Profile, US Core Observation Clinical Result Profile, US Core Simple Observation Profile)
                                                                      Is Modifierfalse
                                                                      Must Supporttrue
                                                                      Must Support TypesNo must-support rules about the choice of types/profiles
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      266. Composition.section:sliceResultsSection.entry:sliceDiagnosticResultEntry
                                                                      Slice NamesliceDiagnosticResultEntry
                                                                      Definition

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

                                                                      ShortDiagnostic Result Entry
                                                                      Comments

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

                                                                      Control0..*
                                                                      This element is affected by the following invariants: cmp-2
                                                                      TypeReference(US Core DiagnosticReport Profile for Laboratory Results Reporting)
                                                                      Is Modifierfalse
                                                                      Must Supporttrue
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      268. Composition.section:sliceResultsSection.emptyReason
                                                                      Definition

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

                                                                      ShortWhy the section is empty
                                                                      Comments

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

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

                                                                      If a section is empty, why it is empty.

                                                                      TypeCodeableConcept
                                                                      Is Modifierfalse
                                                                      Summaryfalse
                                                                      Requirements

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

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

                                                                      A nested sub-section within this section.

                                                                      ShortNested Section
                                                                      Comments

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

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

                                                                      The Notes Section contains clinical notes and diagnostic reports.

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

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

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

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

                                                                      ShortAdditional content defined by implementations
                                                                      Comments

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

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

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

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

                                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                                      Comments

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

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

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

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

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

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

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

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

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

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

                                                                      Clinical Notes Section code

                                                                      ShortClinical Notes Section code
                                                                      Comments

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

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

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

                                                                      Classification of a section of a composition/document.

                                                                      TypeCodeableConcept
                                                                      Is Modifierfalse
                                                                      Must Supporttrue
                                                                      Summaryfalse
                                                                      Requirements

                                                                      Provides computable standardized labels to topics within the document.

                                                                      Pattern Value{
                                                                        "coding" : [{
                                                                          "system" : "http://loinc.org",
                                                                          "code" : "28650-0"
                                                                        }]
                                                                      }
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      284. Composition.section:sliceNotesSection.author
                                                                      Definition

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

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

                                                                      Identifies who is responsible for the content.

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

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

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

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

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

                                                                      Notes Section narrative

                                                                      ShortNotes Section narrative
                                                                      Comments

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

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

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

                                                                      Shortworking | snapshot | changes
                                                                      Comments

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

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

                                                                      The processing mode that applies to this section.

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

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

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

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

                                                                      ShortOrder of section entries
                                                                      Comments

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

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

                                                                      What order applies to the items in the entry.

                                                                      TypeCodeableConcept
                                                                      Is Modifierfalse
                                                                      Summaryfalse
                                                                      Requirements

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

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

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

                                                                      ShortA reference to data that supports this section
                                                                      Comments

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

                                                                      Control0..*
                                                                      This element is affected by the following invariants: cmp-2
                                                                      TypeReference(Resource)
                                                                      Is Modifierfalse
                                                                      Must Supporttrue
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                      • profile @ resolve()
                                                                      • 296. Composition.section:sliceNotesSection.entry:sliceDocumentReferenceEntry
                                                                        Slice NamesliceDocumentReferenceEntry
                                                                        Definition

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

                                                                        ShortDocument Reference Entry
                                                                        Comments

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

                                                                        Control0..*
                                                                        This element is affected by the following invariants: cmp-2
                                                                        TypeReference(US Core DocumentReference Profile)
                                                                        Is Modifierfalse
                                                                        Must Supporttrue
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        298. Composition.section:sliceNotesSection.entry:sliceDiagnosticReportEntry
                                                                        Slice NamesliceDiagnosticReportEntry
                                                                        Definition

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

                                                                        ShortDiagnostic Report Entry
                                                                        Comments

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

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

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

                                                                        ShortWhy the section is empty
                                                                        Comments

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

                                                                        Control0..1
                                                                        This element is affected by the following invariants: cmp-2
                                                                        BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                        (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                        If a section is empty, why it is empty.

                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        302. Composition.section:sliceNotesSection.section
                                                                        Definition

                                                                        A nested sub-section within this section.

                                                                        ShortNested Section
                                                                        Comments

                                                                        Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                        Control0..*
                                                                        This element is affected by the following invariants: cmp-1
                                                                        TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        304. Composition.section:slicePlanOfTreatmentSection
                                                                        Slice NameslicePlanOfTreatmentSection
                                                                        Definition

                                                                        This section, contains data that define pending orders, interventions, encounters, services, and procedures for the patient. It is limited to prospective, unfulfilled, or incomplete orders and requests only. All active, incomplete, or pending orders, appointments, referrals, procedures, services, or any other pending event of clinical significance to the current care of the patient should be listed.

                                                                        ShortPlan of Treatment Section
                                                                        Control0..1
                                                                        TypeBackboneElement
                                                                        Is Modifierfalse
                                                                        Must Supporttrue
                                                                        Summaryfalse
                                                                        Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                        cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        306. Composition.section:slicePlanOfTreatmentSection.id
                                                                        Definition

                                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                        ShortUnique id for inter-element referencing
                                                                        Control0..1
                                                                        Typestring
                                                                        Is Modifierfalse
                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                        Summaryfalse
                                                                        308. Composition.section:slicePlanOfTreatmentSection.extension
                                                                        Definition

                                                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                        ShortAdditional content defined by implementations
                                                                        Comments

                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                        Control0..*
                                                                        TypeExtension
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Alternate Namesextensions, user content
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        310. Composition.section:slicePlanOfTreatmentSection.modifierExtension
                                                                        Definition

                                                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                                        Comments

                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                        Control0..*
                                                                        TypeExtension
                                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                        Summarytrue
                                                                        Requirements

                                                                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                        Alternate Namesextensions, user content, modifiers
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        312. Composition.section:slicePlanOfTreatmentSection.title
                                                                        Definition

                                                                        The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                        ShortLabel for section (e.g. for ToC)
                                                                        Comments

                                                                        The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                        Control0..1
                                                                        Typestring
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                        Alternate Namesheader, label, caption
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        314. Composition.section:slicePlanOfTreatmentSection.code
                                                                        Definition

                                                                        Plan of Treatment code

                                                                        ShortPlan of Treatment code
                                                                        Comments

                                                                        The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                        If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                        Control1..1
                                                                        BindingFor example codes, see DocumentSectionCodes
                                                                        (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                        Classification of a section of a composition/document.

                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Must Supporttrue
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Provides computable standardized labels to topics within the document.

                                                                        Pattern Value{
                                                                          "coding" : [{
                                                                            "system" : "http://loinc.org",
                                                                            "code" : "18776-5"
                                                                          }]
                                                                        }
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        316. Composition.section:slicePlanOfTreatmentSection.author
                                                                        Definition

                                                                        Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                        ShortWho and/or what authored the section
                                                                        Control0..*
                                                                        TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Identifies who is responsible for the content.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        318. Composition.section:slicePlanOfTreatmentSection.focus
                                                                        Definition

                                                                        The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                        ShortWho/what the section is about, when it is not about the subject of composition
                                                                        Comments

                                                                        Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                        Control0..1
                                                                        TypeReference(Resource)
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        320. Composition.section:slicePlanOfTreatmentSection.text
                                                                        Definition

                                                                        Plan of Treatment narrative

                                                                        ShortPlan of Treatment narrative
                                                                        Comments

                                                                        Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                        Control1..1
                                                                        This element is affected by the following invariants: cmp-1
                                                                        TypeNarrative
                                                                        Is Modifierfalse
                                                                        Must Supporttrue
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        322. Composition.section:slicePlanOfTreatmentSection.mode
                                                                        Definition

                                                                        How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                        Shortworking | snapshot | changes
                                                                        Comments

                                                                        This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                        Control0..1
                                                                        BindingThe codes SHALL be taken from ListMode
                                                                        (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                        The processing mode that applies to this section.

                                                                        Typecode
                                                                        Is Modifierfalse
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        324. Composition.section:slicePlanOfTreatmentSection.orderedBy
                                                                        Definition

                                                                        Specifies the order applied to the items in the section entries.

                                                                        ShortOrder of section entries
                                                                        Comments

                                                                        Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                        Control0..1
                                                                        BindingThe codes SHOULD be taken from ListOrderCodes
                                                                        (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                        What order applies to the items in the entry.

                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        326. Composition.section:slicePlanOfTreatmentSection.entry
                                                                        Definition

                                                                        A reference to the actual resource from which the narrative in the section is derived.

                                                                        ShortA reference to data that supports this section
                                                                        Comments

                                                                        If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                        Control0..*
                                                                        This element is affected by the following invariants: cmp-2
                                                                        TypeReference(Resource)
                                                                        Is Modifierfalse
                                                                        Must Supporttrue
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                        • profile @ resolve()
                                                                        • 328. Composition.section:slicePlanOfTreatmentSection.entry:sliceServiceRequests
                                                                          Slice NamesliceServiceRequests
                                                                          Definition

                                                                          A reference to the actual resource from which the narrative in the section is derived.

                                                                          ShortService Request Entry
                                                                          Comments

                                                                          If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                          Control0..*
                                                                          This element is affected by the following invariants: cmp-2
                                                                          TypeReference(eICR ServiceRequest, US Core ServiceRequest Profile)
                                                                          Is Modifierfalse
                                                                          Must Supporttrue
                                                                          Must Support TypesNo must-support rules about the choice of types/profiles
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          330. Composition.section:slicePlanOfTreatmentSection.entry:sliceMedicationRequest
                                                                          Slice NamesliceMedicationRequest
                                                                          Definition

                                                                          A reference to the actual resource from which the narrative in the section is derived.

                                                                          ShortMedication Request Entry
                                                                          Comments

                                                                          If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                          Control0..*
                                                                          This element is affected by the following invariants: cmp-2
                                                                          TypeReference(US Core MedicationRequest Profile)
                                                                          Is Modifierfalse
                                                                          Must Supporttrue
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          332. Composition.section:slicePlanOfTreatmentSection.entry:sliceMedicationReferences
                                                                          Slice NamesliceMedicationReferences
                                                                          Definition

                                                                          A reference to the actual resource from which the narrative in the section is derived.

                                                                          ShortMedication Reference Entry
                                                                          Comments

                                                                          If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                          Control0..*
                                                                          This element is affected by the following invariants: cmp-2
                                                                          TypeReference(US Core Medication Profile)
                                                                          Is Modifierfalse
                                                                          Must Supporttrue
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          334. Composition.section:slicePlanOfTreatmentSection.emptyReason
                                                                          Definition

                                                                          If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                          ShortWhy the section is empty
                                                                          Comments

                                                                          The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                          Control0..1
                                                                          This element is affected by the following invariants: cmp-2
                                                                          BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                          (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                          If a section is empty, why it is empty.

                                                                          TypeCodeableConcept
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Requirements

                                                                          Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          336. Composition.section:slicePlanOfTreatmentSection.section
                                                                          Definition

                                                                          A nested sub-section within this section.

                                                                          ShortNested Section
                                                                          Comments

                                                                          Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                          Control0..*
                                                                          This element is affected by the following invariants: cmp-1
                                                                          TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          338. Composition.section:sliceImmunizationsSection
                                                                          Slice NamesliceImmunizationsSection
                                                                          Definition

                                                                          The Immunizations Section defines a patient's current immunization status and pertinent immunization history. The primary use case for the Immunization Section is to enable communication of a patient's immunization status. The section should include current immunization status, and may contain the entire immunization history that is relevant to the period of time being summarized.

                                                                          ShortImmunizations Section
                                                                          Control0..1
                                                                          TypeBackboneElement
                                                                          Is Modifierfalse
                                                                          Must Supporttrue
                                                                          Summaryfalse
                                                                          Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          340. Composition.section:sliceImmunizationsSection.id
                                                                          Definition

                                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                          ShortUnique id for inter-element referencing
                                                                          Control0..1
                                                                          Typestring
                                                                          Is Modifierfalse
                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                          Summaryfalse
                                                                          342. Composition.section:sliceImmunizationsSection.extension
                                                                          Definition

                                                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                          ShortAdditional content defined by implementations
                                                                          Comments

                                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                          Control0..*
                                                                          TypeExtension
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Alternate Namesextensions, user content
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                          344. Composition.section:sliceImmunizationsSection.modifierExtension
                                                                          Definition

                                                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                                          Comments

                                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                          Control0..*
                                                                          TypeExtension
                                                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                          Summarytrue
                                                                          Requirements

                                                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                          Alternate Namesextensions, user content, modifiers
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                          346. Composition.section:sliceImmunizationsSection.title
                                                                          Definition

                                                                          The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                          ShortLabel for section (e.g. for ToC)
                                                                          Comments

                                                                          The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                          Control0..1
                                                                          Typestring
                                                                          Is Modifierfalse
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summaryfalse
                                                                          Requirements

                                                                          Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                          Alternate Namesheader, label, caption
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          348. Composition.section:sliceImmunizationsSection.code
                                                                          Definition

                                                                          Immunizations code

                                                                          ShortImmunizations code
                                                                          Comments

                                                                          The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                          If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                          Control1..1
                                                                          BindingFor example codes, see DocumentSectionCodes
                                                                          (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                          Classification of a section of a composition/document.

                                                                          TypeCodeableConcept
                                                                          Is Modifierfalse
                                                                          Must Supporttrue
                                                                          Summaryfalse
                                                                          Requirements

                                                                          Provides computable standardized labels to topics within the document.

                                                                          Pattern Value{
                                                                            "coding" : [{
                                                                              "system" : "http://loinc.org",
                                                                              "code" : "11369-6"
                                                                            }]
                                                                          }
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          350. Composition.section:sliceImmunizationsSection.author
                                                                          Definition

                                                                          Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                          ShortWho and/or what authored the section
                                                                          Control0..*
                                                                          TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Requirements

                                                                          Identifies who is responsible for the content.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          352. Composition.section:sliceImmunizationsSection.focus
                                                                          Definition

                                                                          The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                          ShortWho/what the section is about, when it is not about the subject of composition
                                                                          Comments

                                                                          Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                          Control0..1
                                                                          TypeReference(Resource)
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          354. Composition.section:sliceImmunizationsSection.text
                                                                          Definition

                                                                          Immunizations narrative

                                                                          ShortImmunizations narrative
                                                                          Comments

                                                                          Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                          Control1..1
                                                                          This element is affected by the following invariants: cmp-1
                                                                          TypeNarrative
                                                                          Is Modifierfalse
                                                                          Must Supporttrue
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          356. Composition.section:sliceImmunizationsSection.mode
                                                                          Definition

                                                                          How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                          Shortworking | snapshot | changes
                                                                          Comments

                                                                          This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                          Control0..1
                                                                          BindingThe codes SHALL be taken from ListMode
                                                                          (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                          The processing mode that applies to this section.

                                                                          Typecode
                                                                          Is Modifierfalse
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summaryfalse
                                                                          Requirements

                                                                          Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          358. Composition.section:sliceImmunizationsSection.orderedBy
                                                                          Definition

                                                                          Specifies the order applied to the items in the section entries.

                                                                          ShortOrder of section entries
                                                                          Comments

                                                                          Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                          Control0..1
                                                                          BindingThe codes SHOULD be taken from ListOrderCodes
                                                                          (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                          What order applies to the items in the entry.

                                                                          TypeCodeableConcept
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Requirements

                                                                          Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          360. Composition.section:sliceImmunizationsSection.entry
                                                                          Definition

                                                                          A reference to the actual resource from which the narrative in the section is derived.

                                                                          ShortA reference to data that supports this section
                                                                          Comments

                                                                          If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                          Control0..*
                                                                          This element is affected by the following invariants: cmp-2
                                                                          TypeReference(Resource)
                                                                          Is Modifierfalse
                                                                          Must Supporttrue
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                          • profile @ resolve()
                                                                          • 362. Composition.section:sliceImmunizationsSection.entry:sliceImmunizations
                                                                            Slice NamesliceImmunizations
                                                                            Definition

                                                                            A reference to the actual resource from which the narrative in the section is derived.

                                                                            ShortImmunizations Entry
                                                                            Comments

                                                                            If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                            Control0..*
                                                                            This element is affected by the following invariants: cmp-2
                                                                            TypeReference(US Core Immunization Profile)
                                                                            Is Modifierfalse
                                                                            Must Supporttrue
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            364. Composition.section:sliceImmunizationsSection.emptyReason
                                                                            Definition

                                                                            If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                            ShortWhy the section is empty
                                                                            Comments

                                                                            The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                            Control0..1
                                                                            This element is affected by the following invariants: cmp-2
                                                                            BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                            (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                            If a section is empty, why it is empty.

                                                                            TypeCodeableConcept
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            366. Composition.section:sliceImmunizationsSection.section
                                                                            Definition

                                                                            A nested sub-section within this section.

                                                                            ShortNested Section
                                                                            Comments

                                                                            Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                            Control0..*
                                                                            This element is affected by the following invariants: cmp-1
                                                                            TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            368. Composition.section:sliceProceduresSection
                                                                            Slice NamesliceProceduresSection
                                                                            Definition

                                                                            This section describes all interventional, surgical, diagnostic, or therapeutic procedures or treatments pertinent to the patient historically at the time the document is generated. The section should include notable procedures, but can contain all procedures for the period of time being summarized.

                                                                            ShortThis section describes all interventional, surgical, diagnostic, or therapeutic procedures or treatments pertinent to the patient historically at the time the document is generated.
                                                                            Control0..1
                                                                            TypeBackboneElement
                                                                            Is Modifierfalse
                                                                            Must Supporttrue
                                                                            Summaryfalse
                                                                            Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            370. Composition.section:sliceProceduresSection.id
                                                                            Definition

                                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                            ShortUnique id for inter-element referencing
                                                                            Control0..1
                                                                            Typestring
                                                                            Is Modifierfalse
                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                            Summaryfalse
                                                                            372. Composition.section:sliceProceduresSection.extension
                                                                            Definition

                                                                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                            ShortAdditional content defined by implementations
                                                                            Comments

                                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                            Control0..*
                                                                            TypeExtension
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Alternate Namesextensions, user content
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                            374. Composition.section:sliceProceduresSection.modifierExtension
                                                                            Definition

                                                                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                                            Comments

                                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                            Control0..*
                                                                            TypeExtension
                                                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                            Summarytrue
                                                                            Requirements

                                                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                            Alternate Namesextensions, user content, modifiers
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                            376. Composition.section:sliceProceduresSection.title
                                                                            Definition

                                                                            The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                            ShortLabel for section (e.g. for ToC)
                                                                            Comments

                                                                            The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                            Control0..1
                                                                            Typestring
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                            Alternate Namesheader, label, caption
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            378. Composition.section:sliceProceduresSection.code
                                                                            Definition

                                                                            Procedures Section code

                                                                            ShortProcedures Section code
                                                                            Comments

                                                                            The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                            If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                            Control1..1
                                                                            BindingFor example codes, see DocumentSectionCodes
                                                                            (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                            Classification of a section of a composition/document.

                                                                            TypeCodeableConcept
                                                                            Is Modifierfalse
                                                                            Must Supporttrue
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Provides computable standardized labels to topics within the document.

                                                                            Pattern Value{
                                                                              "coding" : [{
                                                                                "system" : "http://loinc.org",
                                                                                "code" : "47519-4"
                                                                              }]
                                                                            }
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            380. Composition.section:sliceProceduresSection.author
                                                                            Definition

                                                                            Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                            ShortWho and/or what authored the section
                                                                            Control0..*
                                                                            TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Identifies who is responsible for the content.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            382. Composition.section:sliceProceduresSection.focus
                                                                            Definition

                                                                            The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                            ShortWho/what the section is about, when it is not about the subject of composition
                                                                            Comments

                                                                            Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                            Control0..1
                                                                            TypeReference(Resource)
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            384. Composition.section:sliceProceduresSection.text
                                                                            Definition

                                                                            Procedures Section narrative

                                                                            ShortProcedures Section narrative
                                                                            Comments

                                                                            Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                            Control1..1
                                                                            This element is affected by the following invariants: cmp-1
                                                                            TypeNarrative
                                                                            Is Modifierfalse
                                                                            Must Supporttrue
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            386. Composition.section:sliceProceduresSection.mode
                                                                            Definition

                                                                            How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                            Shortworking | snapshot | changes
                                                                            Comments

                                                                            This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                            Control0..1
                                                                            BindingThe codes SHALL be taken from ListMode
                                                                            (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                            The processing mode that applies to this section.

                                                                            Typecode
                                                                            Is Modifierfalse
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            388. Composition.section:sliceProceduresSection.orderedBy
                                                                            Definition

                                                                            Specifies the order applied to the items in the section entries.

                                                                            ShortOrder of section entries
                                                                            Comments

                                                                            Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                            Control0..1
                                                                            BindingThe codes SHOULD be taken from ListOrderCodes
                                                                            (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                            What order applies to the items in the entry.

                                                                            TypeCodeableConcept
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            390. Composition.section:sliceProceduresSection.entry
                                                                            Definition

                                                                            A reference to the actual resource from which the narrative in the section is derived.

                                                                            ShortA reference to data that supports this section
                                                                            Comments

                                                                            If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                            Control0..*
                                                                            This element is affected by the following invariants: cmp-2
                                                                            TypeReference(Resource)
                                                                            Is Modifierfalse
                                                                            Must Supporttrue
                                                                            Summaryfalse
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                            • profile @ resolve()
                                                                            • 392. Composition.section:sliceProceduresSection.entry:sliceProcedures
                                                                              Slice NamesliceProcedures
                                                                              Definition

                                                                              A reference to the actual resource from which the narrative in the section is derived.

                                                                              ShortProcedures Entry
                                                                              Comments

                                                                              If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                              Control0..*
                                                                              This element is affected by the following invariants: cmp-2
                                                                              TypeReference(eICR Procedure)
                                                                              Is Modifierfalse
                                                                              Must Supporttrue
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              394. Composition.section:sliceProceduresSection.emptyReason
                                                                              Definition

                                                                              If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                              ShortWhy the section is empty
                                                                              Comments

                                                                              The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                              Control0..1
                                                                              This element is affected by the following invariants: cmp-2
                                                                              BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                              (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                              If a section is empty, why it is empty.

                                                                              TypeCodeableConcept
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Requirements

                                                                              Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              396. Composition.section:sliceProceduresSection.section
                                                                              Definition

                                                                              A nested sub-section within this section.

                                                                              ShortNested Section
                                                                              Comments

                                                                              Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                              Control0..*
                                                                              This element is affected by the following invariants: cmp-1
                                                                              TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              398. Composition.section:sliceVitalSignsSection
                                                                              Slice NamesliceVitalSignsSection
                                                                              Definition

                                                                              The Vital Signs Section contains relevant vital signs for the eICR. The section should include notable vital signs such as the most recent, maximum and/or minimum, baseline, or relevant trends. Vital signs are represented in the same way as other results, but are aggregated into their own section to follow clinical conventions.

                                                                              ShortVital Signs Section
                                                                              Control0..1
                                                                              TypeBackboneElement
                                                                              Is Modifierfalse
                                                                              Must Supporttrue
                                                                              Summaryfalse
                                                                              Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              400. Composition.section:sliceVitalSignsSection.id
                                                                              Definition

                                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                              ShortUnique id for inter-element referencing
                                                                              Control0..1
                                                                              Typestring
                                                                              Is Modifierfalse
                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                              Summaryfalse
                                                                              402. Composition.section:sliceVitalSignsSection.extension
                                                                              Definition

                                                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                              ShortAdditional content defined by implementations
                                                                              Comments

                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                              Control0..*
                                                                              TypeExtension
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Alternate Namesextensions, user content
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                              404. Composition.section:sliceVitalSignsSection.modifierExtension
                                                                              Definition

                                                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                                              Comments

                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                              Control0..*
                                                                              TypeExtension
                                                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                              Summarytrue
                                                                              Requirements

                                                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                              Alternate Namesextensions, user content, modifiers
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                              406. Composition.section:sliceVitalSignsSection.title
                                                                              Definition

                                                                              The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                              ShortLabel for section (e.g. for ToC)
                                                                              Comments

                                                                              The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                              Control0..1
                                                                              Typestring
                                                                              Is Modifierfalse
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summaryfalse
                                                                              Requirements

                                                                              Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                              Alternate Namesheader, label, caption
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              408. Composition.section:sliceVitalSignsSection.code
                                                                              Definition

                                                                              Vital Signs code

                                                                              ShortVital Signs code
                                                                              Comments

                                                                              The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                              If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                              Control1..1
                                                                              BindingFor example codes, see DocumentSectionCodes
                                                                              (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                              Classification of a section of a composition/document.

                                                                              TypeCodeableConcept
                                                                              Is Modifierfalse
                                                                              Must Supporttrue
                                                                              Summaryfalse
                                                                              Requirements

                                                                              Provides computable standardized labels to topics within the document.

                                                                              Pattern Value{
                                                                                "coding" : [{
                                                                                  "system" : "http://loinc.org",
                                                                                  "code" : "8716-3"
                                                                                }]
                                                                              }
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              410. Composition.section:sliceVitalSignsSection.author
                                                                              Definition

                                                                              Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                              ShortWho and/or what authored the section
                                                                              Control0..*
                                                                              TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Requirements

                                                                              Identifies who is responsible for the content.

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              412. Composition.section:sliceVitalSignsSection.focus
                                                                              Definition

                                                                              The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                              ShortWho/what the section is about, when it is not about the subject of composition
                                                                              Comments

                                                                              Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                              Control0..1
                                                                              TypeReference(Resource)
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              414. Composition.section:sliceVitalSignsSection.text
                                                                              Definition

                                                                              Vital Signs narrative

                                                                              ShortVital Signs narrative
                                                                              Comments

                                                                              Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                              Control1..1
                                                                              This element is affected by the following invariants: cmp-1
                                                                              TypeNarrative
                                                                              Is Modifierfalse
                                                                              Must Supporttrue
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              416. Composition.section:sliceVitalSignsSection.mode
                                                                              Definition

                                                                              How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                              Shortworking | snapshot | changes
                                                                              Comments

                                                                              This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                              Control0..1
                                                                              BindingThe codes SHALL be taken from ListMode
                                                                              (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                              The processing mode that applies to this section.

                                                                              Typecode
                                                                              Is Modifierfalse
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summaryfalse
                                                                              Requirements

                                                                              Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              418. Composition.section:sliceVitalSignsSection.orderedBy
                                                                              Definition

                                                                              Specifies the order applied to the items in the section entries.

                                                                              ShortOrder of section entries
                                                                              Comments

                                                                              Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                              Control0..1
                                                                              BindingThe codes SHOULD be taken from ListOrderCodes
                                                                              (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                              What order applies to the items in the entry.

                                                                              TypeCodeableConcept
                                                                              Is Modifierfalse
                                                                              Summaryfalse
                                                                              Requirements

                                                                              Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              420. Composition.section:sliceVitalSignsSection.entry
                                                                              Definition

                                                                              A reference to the actual resource from which the narrative in the section is derived.

                                                                              ShortA reference to data that supports this section
                                                                              Comments

                                                                              If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                              Control0..*
                                                                              This element is affected by the following invariants: cmp-2
                                                                              TypeReference(Resource)
                                                                              Is Modifierfalse
                                                                              Must Supporttrue
                                                                              Summaryfalse
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                              • profile @ resolve()
                                                                              • 422. Composition.section:sliceVitalSignsSection.entry:sliceVitalSigns
                                                                                Slice NamesliceVitalSigns
                                                                                Definition

                                                                                A reference to the actual resource from which the narrative in the section is derived.

                                                                                ShortVital Signs Entry
                                                                                Comments

                                                                                If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                Control0..*
                                                                                This element is affected by the following invariants: cmp-2
                                                                                TypeReference(US Core Vital Signs Profile)
                                                                                Is Modifierfalse
                                                                                Must Supporttrue
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                424. Composition.section:sliceVitalSignsSection.emptyReason
                                                                                Definition

                                                                                If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                ShortWhy the section is empty
                                                                                Comments

                                                                                The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                Control0..1
                                                                                This element is affected by the following invariants: cmp-2
                                                                                BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                                If a section is empty, why it is empty.

                                                                                TypeCodeableConcept
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Requirements

                                                                                Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                426. Composition.section:sliceVitalSignsSection.section
                                                                                Definition

                                                                                A nested sub-section within this section.

                                                                                ShortNested Section
                                                                                Comments

                                                                                Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                Control0..*
                                                                                This element is affected by the following invariants: cmp-1
                                                                                TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                428. Composition.section:sliceSocialHistorySection
                                                                                Slice NamesliceSocialHistorySection
                                                                                Definition

                                                                                This section contains social history data that influence a patient’s physical, psychological or emotional health such as occupation, home environment, travel history, and disability status.

                                                                                ShortSocial History Section
                                                                                Control0..1
                                                                                TypeBackboneElement
                                                                                Is Modifierfalse
                                                                                Must Supporttrue
                                                                                Summaryfalse
                                                                                Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                430. Composition.section:sliceSocialHistorySection.id
                                                                                Definition

                                                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                ShortUnique id for inter-element referencing
                                                                                Control0..1
                                                                                Typestring
                                                                                Is Modifierfalse
                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                Summaryfalse
                                                                                432. Composition.section:sliceSocialHistorySection.extension
                                                                                Definition

                                                                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                ShortAdditional content defined by implementations
                                                                                Comments

                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                Control0..*
                                                                                TypeExtension
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Alternate Namesextensions, user content
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                434. Composition.section:sliceSocialHistorySection.modifierExtension
                                                                                Definition

                                                                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                                Comments

                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                Control0..*
                                                                                TypeExtension
                                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                Summarytrue
                                                                                Requirements

                                                                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                Alternate Namesextensions, user content, modifiers
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                436. Composition.section:sliceSocialHistorySection.title
                                                                                Definition

                                                                                The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                ShortLabel for section (e.g. for ToC)
                                                                                Comments

                                                                                The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                Control0..1
                                                                                Typestring
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Summaryfalse
                                                                                Requirements

                                                                                Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                Alternate Namesheader, label, caption
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                438. Composition.section:sliceSocialHistorySection.code
                                                                                Definition

                                                                                Social History Section code

                                                                                ShortSocial History Section code
                                                                                Comments

                                                                                The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                Control1..1
                                                                                BindingFor example codes, see DocumentSectionCodes
                                                                                (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                Classification of a section of a composition/document.

                                                                                TypeCodeableConcept
                                                                                Is Modifierfalse
                                                                                Must Supporttrue
                                                                                Summaryfalse
                                                                                Requirements

                                                                                Provides computable standardized labels to topics within the document.

                                                                                Pattern Value{
                                                                                  "coding" : [{
                                                                                    "system" : "http://loinc.org",
                                                                                    "code" : "29762-2"
                                                                                  }]
                                                                                }
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                440. Composition.section:sliceSocialHistorySection.author
                                                                                Definition

                                                                                Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                ShortWho and/or what authored the section
                                                                                Control0..*
                                                                                TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Requirements

                                                                                Identifies who is responsible for the content.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                442. Composition.section:sliceSocialHistorySection.focus
                                                                                Definition

                                                                                The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                ShortWho/what the section is about, when it is not about the subject of composition
                                                                                Comments

                                                                                Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                Control0..1
                                                                                TypeReference(Resource)
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                444. Composition.section:sliceSocialHistorySection.text
                                                                                Definition

                                                                                Social History Section narrative

                                                                                ShortSocial History Section narrative
                                                                                Comments

                                                                                Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                Control1..1
                                                                                This element is affected by the following invariants: cmp-1
                                                                                TypeNarrative
                                                                                Is Modifierfalse
                                                                                Must Supporttrue
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                446. Composition.section:sliceSocialHistorySection.mode
                                                                                Definition

                                                                                How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                Shortworking | snapshot | changes
                                                                                Comments

                                                                                This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                Control0..1
                                                                                BindingThe codes SHALL be taken from ListMode
                                                                                (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                The processing mode that applies to this section.

                                                                                Typecode
                                                                                Is Modifierfalse
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Summaryfalse
                                                                                Requirements

                                                                                Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                448. Composition.section:sliceSocialHistorySection.orderedBy
                                                                                Definition

                                                                                Specifies the order applied to the items in the section entries.

                                                                                ShortOrder of section entries
                                                                                Comments

                                                                                Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                Control0..1
                                                                                BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                What order applies to the items in the entry.

                                                                                TypeCodeableConcept
                                                                                Is Modifierfalse
                                                                                Summaryfalse
                                                                                Requirements

                                                                                Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                450. Composition.section:sliceSocialHistorySection.entry
                                                                                Definition

                                                                                A reference to the actual resource from which the narrative in the section is derived.

                                                                                ShortA reference to data that supports this section
                                                                                Comments

                                                                                If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                Control0..*
                                                                                This element is affected by the following invariants: cmp-2
                                                                                TypeReference(Resource)
                                                                                Is Modifierfalse
                                                                                Must Supporttrue
                                                                                Summaryfalse
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                • profile @ resolve()
                                                                                • 452. Composition.section:sliceSocialHistorySection.entry:sliceSocialHistoryObservations
                                                                                  Slice NamesliceSocialHistoryObservations
                                                                                  Definition

                                                                                  Social History Observation entries

                                                                                  ShortSocial History Observations
                                                                                  Comments

                                                                                  If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                  Control0..*
                                                                                  This element is affected by the following invariants: cmp-2
                                                                                  TypeReference(US Core Smoking Status Observation Profile, US Public Health Disability Status, US Core Simple Observation Profile, US Public Health Characteristics of Home Environment)
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Must Support TypesNo must-support rules about the choice of types/profiles
                                                                                  Summaryfalse
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  454. Composition.section:sliceSocialHistorySection.emptyReason
                                                                                  Definition

                                                                                  If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                  ShortWhy the section is empty
                                                                                  Comments

                                                                                  The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                  Control0..1
                                                                                  This element is affected by the following invariants: cmp-2
                                                                                  BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                  (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                                  If a section is empty, why it is empty.

                                                                                  TypeCodeableConcept
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  456. Composition.section:sliceSocialHistorySection.section
                                                                                  Definition

                                                                                  A nested sub-section within this section.

                                                                                  ShortNested Section
                                                                                  Comments

                                                                                  Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                  Control0..*
                                                                                  This element is affected by the following invariants: cmp-1
                                                                                  TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  458. Composition.section:slicePregnancySection
                                                                                  Slice NameslicePregnancySection
                                                                                  Definition

                                                                                  This section contains pregnancy data

                                                                                  ShortPregnancy Section
                                                                                  Control0..1
                                                                                  TypeBackboneElement
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Summaryfalse
                                                                                  Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                  cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                  ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  460. Composition.section:slicePregnancySection.id
                                                                                  Definition

                                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                  ShortUnique id for inter-element referencing
                                                                                  Control0..1
                                                                                  Typestring
                                                                                  Is Modifierfalse
                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                  Summaryfalse
                                                                                  462. Composition.section:slicePregnancySection.extension
                                                                                  Definition

                                                                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                  ShortAdditional content defined by implementations
                                                                                  Comments

                                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                  Control0..*
                                                                                  TypeExtension
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Alternate Namesextensions, user content
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  464. Composition.section:slicePregnancySection.modifierExtension
                                                                                  Definition

                                                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                                                  Comments

                                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                  Control0..*
                                                                                  TypeExtension
                                                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                  Alternate Namesextensions, user content, modifiers
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  466. Composition.section:slicePregnancySection.title
                                                                                  Definition

                                                                                  The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                  ShortLabel for section (e.g. for ToC)
                                                                                  Comments

                                                                                  The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                  Control0..1
                                                                                  Typestring
                                                                                  Is Modifierfalse
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                  Alternate Namesheader, label, caption
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  468. Composition.section:slicePregnancySection.code
                                                                                  Definition

                                                                                  Pregnancy Section code

                                                                                  ShortPregnancy Section code
                                                                                  Comments

                                                                                  The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                  If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                  Control1..1
                                                                                  BindingFor example codes, see DocumentSectionCodes
                                                                                  (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                  Classification of a section of a composition/document.

                                                                                  TypeCodeableConcept
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  Provides computable standardized labels to topics within the document.

                                                                                  Pattern Value{
                                                                                    "coding" : [{
                                                                                      "system" : "http://loinc.org",
                                                                                      "code" : "90767-5"
                                                                                    }]
                                                                                  }
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  470. Composition.section:slicePregnancySection.author
                                                                                  Definition

                                                                                  Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                                                  ShortWho and/or what authored the section
                                                                                  Control0..*
                                                                                  TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  Identifies who is responsible for the content.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  472. Composition.section:slicePregnancySection.focus
                                                                                  Definition

                                                                                  The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                  ShortWho/what the section is about, when it is not about the subject of composition
                                                                                  Comments

                                                                                  Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                  Control0..1
                                                                                  TypeReference(Resource)
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  474. Composition.section:slicePregnancySection.text
                                                                                  Definition

                                                                                  Pregnancy Section narrative

                                                                                  ShortPregnancy Section narrative
                                                                                  Comments

                                                                                  Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                  Control1..1
                                                                                  This element is affected by the following invariants: cmp-1
                                                                                  TypeNarrative
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Summaryfalse
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  476. Composition.section:slicePregnancySection.mode
                                                                                  Definition

                                                                                  How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                  Shortworking | snapshot | changes
                                                                                  Comments

                                                                                  This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                  Control0..1
                                                                                  BindingThe codes SHALL be taken from ListMode
                                                                                  (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                  The processing mode that applies to this section.

                                                                                  Typecode
                                                                                  Is Modifierfalse
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  478. Composition.section:slicePregnancySection.orderedBy
                                                                                  Definition

                                                                                  Specifies the order applied to the items in the section entries.

                                                                                  ShortOrder of section entries
                                                                                  Comments

                                                                                  Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                  Control0..1
                                                                                  BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                  (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                  What order applies to the items in the entry.

                                                                                  TypeCodeableConcept
                                                                                  Is Modifierfalse
                                                                                  Summaryfalse
                                                                                  Requirements

                                                                                  Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  480. Composition.section:slicePregnancySection.entry
                                                                                  Definition

                                                                                  A reference to the actual resource from which the narrative in the section is derived.

                                                                                  ShortA reference to data that supports this section
                                                                                  Comments

                                                                                  If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                  Control0..*
                                                                                  This element is affected by the following invariants: cmp-2
                                                                                  TypeReference(Resource)
                                                                                  Is Modifierfalse
                                                                                  Must Supporttrue
                                                                                  Summaryfalse
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                  • profile @ resolve()
                                                                                  • 482. Composition.section:slicePregnancySection.entry:slicePregnancyOutcome
                                                                                    Slice NameslicePregnancyOutcome
                                                                                    Definition

                                                                                    Pregnancy Outcome entry

                                                                                    ShortPregnancy Outcome
                                                                                    Comments

                                                                                    If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                    Control0..*
                                                                                    This element is affected by the following invariants: cmp-2
                                                                                    TypeReference(US Public Health Pregnancy Outcome Observation)
                                                                                    Is Modifierfalse
                                                                                    Must Supporttrue
                                                                                    Summaryfalse
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    484. Composition.section:slicePregnancySection.entry:slicePregnancyStatusObservation
                                                                                    Slice NameslicePregnancyStatusObservation
                                                                                    Definition

                                                                                    Pregnancy Status Observation Entry

                                                                                    ShortPregnancy Status Observation
                                                                                    Comments

                                                                                    If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                    Control0..*
                                                                                    This element is affected by the following invariants: cmp-2
                                                                                    TypeReference(US Core Observation Pregnancy Status Profile)
                                                                                    Is Modifierfalse
                                                                                    Must Supporttrue
                                                                                    Summaryfalse
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    486. Composition.section:slicePregnancySection.entry:slicePostpartumStatus
                                                                                    Slice NameslicePostpartumStatus
                                                                                    Definition

                                                                                    Postpartum Status Entry

                                                                                    ShortPostpartum Status
                                                                                    Comments

                                                                                    If there are no entries in the list, an emptyReason SHOULD be provided.

                                                                                    Control0..*
                                                                                    This element is affected by the following invariants: cmp-2
                                                                                    TypeReference(US Public Health Postpartum Status)
                                                                                    Is Modifierfalse
                                                                                    Must Supporttrue
                                                                                    Summaryfalse
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    488. Composition.section:slicePregnancySection.emptyReason
                                                                                    Definition

                                                                                    If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                    ShortWhy the section is empty
                                                                                    Comments

                                                                                    The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: cmp-2
                                                                                    BindingThe codes SHOULD be taken from ListEmptyReasons
                                                                                    (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                                    If a section is empty, why it is empty.

                                                                                    TypeCodeableConcept
                                                                                    Is Modifierfalse
                                                                                    Summaryfalse
                                                                                    Requirements

                                                                                    Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    490. Composition.section:slicePregnancySection.section
                                                                                    Definition

                                                                                    A nested sub-section within this section.

                                                                                    ShortNested Section
                                                                                    Comments

                                                                                    Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                    Control0..*
                                                                                    This element is affected by the following invariants: cmp-1
                                                                                    TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                    Is Modifierfalse
                                                                                    Summaryfalse
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))