Extensions for Using Data Elements from FHIR STU3 in FHIR R4
0.1.0 - STU
Extensions for Using Data Elements from FHIR STU3 in FHIR R4
0.1.0 - STU
Extensions for Using Data Elements from FHIR STU3 in FHIR R4 - Downloaded Version null See the Directory of published versions
| Page standards status: Trial-use | Maturity Level: 0 |
<ConceptMap xmlns="http://hl7.org/fhir">
<id value="R3-ClinicalImpression-element-map-to-R4"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: ConceptMap R3-ClinicalImpression-element-map-to-R4</b></p><a name="R3-ClinicalImpression-element-map-to-R4"> </a><a name="hcR3-ClinicalImpression-element-map-to-R4"> </a><p>Mapping from http://hl7.org/fhir/3.0 to http://hl7.org/fhir/4.0</p><br/><p><b>Group 1 </b>Mapping from <code>http://hl7.org/fhir/StructureDefinition/ClinicalImpression|3.0.2</code> to <a href="http://hl7.org/fhir/R4/clinicalimpression.html">ClinicalImpressionversion: 4.0.1)</a></p><table class="grid"><tr><td colspan="2"><b>Source Concept Details</b></td><td><b>Relationship</b></td><td colspan="2"><b>Target Concept Details</b></td><td><b>Comment</b></td></tr><tr><td colspan="2"><b>Codes</b> from http://hl7.org/fhir/StructureDefinition/ClinicalImpression|3.0.2</td><td/><td colspan="2" title="http://hl7.org/fhir/StructureDefinition/ClinicalImpression|4.0.1"><b>Codes</b> from ClinicalImpression</td><td/></tr><tr><td style="border-right-width: 0px">ClinicalImpression.meta</td><td style="border-left-width: 0px">meta</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td style="border-right-width: 0px">ClinicalImpression.meta</td><td style="border-left-width: 0px">ClinicalImpression.meta</td><td>Element `ClinicalImpression.meta` is mapped to FHIR R4 element `ClinicalImpression.meta` as `Equivalent`.</td></tr><tr><td style="border-right-width: 0px">ClinicalImpression.implicitRules</td><td style="border-left-width: 0px">implicitRules</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td style="border-right-width: 0px">ClinicalImpression.implicitRules</td><td style="border-left-width: 0px">ClinicalImpression.implicitRules</td><td>Element `ClinicalImpression.implicitRules` is mapped to FHIR R4 element `ClinicalImpression.implicitRules` as `Equivalent`.
Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.
This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.</td></tr><tr><td style="border-right-width: 0px">ClinicalImpression.language</td><td style="border-left-width: 0px">language</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td style="border-right-width: 0px">ClinicalImpression.language</td><td style="border-left-width: 0px">ClinicalImpression.language</td><td>Element `ClinicalImpression.language` is mapped to FHIR R4 element `ClinicalImpression.language` as `Equivalent`.
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).</td></tr><tr><td style="border-right-width: 0px">ClinicalImpression.text</td><td style="border-left-width: 0px">text</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td style="border-right-width: 0px">ClinicalImpression.text</td><td style="border-left-width: 0px">ClinicalImpression.text</td><td>Element `ClinicalImpression.text` is mapped to FHIR R4 element `ClinicalImpression.text` as `Equivalent`.
Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.</td></tr><tr><td style="border-right-width: 0px">ClinicalImpression.contained</td><td style="border-left-width: 0px">contained</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td style="border-right-width: 0px">ClinicalImpression.contained</td><td style="border-left-width: 0px">ClinicalImpression.contained</td><td>Element `ClinicalImpression.contained` is mapped to FHIR R4 element `ClinicalImpression.contained` as `Equivalent`.
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.</td></tr><tr><td style="border-right-width: 0px">ClinicalImpression.identifier</td><td style="border-left-width: 0px">identifier</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td style="border-right-width: 0px">ClinicalImpression.identifier</td><td style="border-left-width: 0px">ClinicalImpression.identifier</td><td>Element `ClinicalImpression.identifier` is mapped to FHIR R4 element `ClinicalImpression.identifier` as `Equivalent`.</td></tr><tr><td style="border-right-width: 0px">ClinicalImpression.status</td><td style="border-left-width: 0px">status</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td style="border-right-width: 0px">ClinicalImpression.status</td><td style="border-left-width: 0px">ClinicalImpression.status</td><td>Element `ClinicalImpression.status` is mapped to FHIR R4 element `ClinicalImpression.status` as `Equivalent`.
This element is labeled as a modifier because the status contains the code entered-in-error that marks the clinical impression as not currently valid.</td></tr><tr><td style="border-right-width: 0px">ClinicalImpression.code</td><td style="border-left-width: 0px">code</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td style="border-right-width: 0px">ClinicalImpression.code</td><td style="border-left-width: 0px">ClinicalImpression.code</td><td>Element `ClinicalImpression.code` is mapped to FHIR R4 element `ClinicalImpression.code` as `Equivalent`.
This is present as a place-holder only and may be removed based on feedback/work group opinion.</td></tr><tr><td style="border-right-width: 0px">ClinicalImpression.description</td><td style="border-left-width: 0px">description</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td style="border-right-width: 0px">ClinicalImpression.description</td><td style="border-left-width: 0px">ClinicalImpression.description</td><td>Element `ClinicalImpression.description` is mapped to FHIR R4 element `ClinicalImpression.description` as `Equivalent`.</td></tr><tr><td style="border-right-width: 0px">ClinicalImpression.subject</td><td style="border-left-width: 0px">subject</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td style="border-right-width: 0px">ClinicalImpression.subject</td><td style="border-left-width: 0px">ClinicalImpression.subject</td><td>Element `ClinicalImpression.subject` is mapped to FHIR R4 element `ClinicalImpression.subject` as `Equivalent`.</td></tr><tr><td style="border-right-width: 0px">ClinicalImpression.context</td><td style="border-left-width: 0px">context</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#wider" title="wider">maps to wider concept</a></td><td style="border-right-width: 0px">ClinicalImpression.encounter</td><td style="border-left-width: 0px">ClinicalImpression.encounter</td><td>Element `ClinicalImpression.context` is mapped to FHIR R4 element `ClinicalImpression.encounter` as `SourceIsBroaderThanTarget`.
The mappings for `ClinicalImpression.context` do not cover the following types based on type expansion: display, identifier, reference.
The standard extension `alternate-reference` has been mapped as the representation of FHIR STU3 element `ClinicalImpression.context` with unmapped reference targets: EpisodeOfCare.</td></tr><tr><td style="border-right-width: 0px">ClinicalImpression.effective[x]</td><td style="border-left-width: 0px">effective[x]</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td style="border-right-width: 0px">ClinicalImpression.effective[x]</td><td style="border-left-width: 0px">ClinicalImpression.effective[x]</td><td>Element `ClinicalImpression.effective[x]` is mapped to FHIR R4 element `ClinicalImpression.effective[x]` as `Equivalent`.
The target context `ClinicalImpression.effective[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `ClinicalImpression`.
This SHOULD be accurate to at least the minute, though some assessments only have a known date.</td></tr><tr><td style="border-right-width: 0px">ClinicalImpression.date</td><td style="border-left-width: 0px">date</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td style="border-right-width: 0px">ClinicalImpression.date</td><td style="border-left-width: 0px">ClinicalImpression.date</td><td>Element `ClinicalImpression.date` is mapped to FHIR R4 element `ClinicalImpression.date` as `Equivalent`.</td></tr><tr><td style="border-right-width: 0px">ClinicalImpression.assessor</td><td style="border-left-width: 0px">assessor</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td style="border-right-width: 0px">ClinicalImpression.assessor</td><td style="border-left-width: 0px">ClinicalImpression.assessor</td><td>Element `ClinicalImpression.assessor` is mapped to FHIR R4 element `ClinicalImpression.assessor` as `Equivalent`.</td></tr><tr><td style="border-right-width: 0px">ClinicalImpression.previous</td><td style="border-left-width: 0px">previous</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td style="border-right-width: 0px">ClinicalImpression.previous</td><td style="border-left-width: 0px">ClinicalImpression.previous</td><td>Element `ClinicalImpression.previous` is mapped to FHIR R4 element `ClinicalImpression.previous` as `Equivalent`.
It is always likely that multiple previous assessments exist for a patient. The point of quoting a previous assessment is that this assessment is relative to it (see resolved).</td></tr><tr><td style="border-right-width: 0px">ClinicalImpression.problem</td><td style="border-left-width: 0px">problem</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td style="border-right-width: 0px">ClinicalImpression.problem</td><td style="border-left-width: 0px">ClinicalImpression.problem</td><td>Element `ClinicalImpression.problem` is mapped to FHIR R4 element `ClinicalImpression.problem` as `Equivalent`.
e.g. The patient is a pregnant, and cardiac congestive failure, ‎Adenocarcinoma, and is allergic to penicillin.</td></tr><tr><td style="border-right-width: 0px">ClinicalImpression.investigation</td><td style="border-left-width: 0px">investigation</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#wider" title="wider">maps to wider concept</a></td><td style="border-right-width: 0px">ClinicalImpression.investigation</td><td style="border-left-width: 0px">ClinicalImpression.investigation</td><td>Element `ClinicalImpression.investigation` is mapped to FHIR R4 element `ClinicalImpression.investigation` as `Equivalent`.</td></tr><tr><td style="border-right-width: 0px">ClinicalImpression.investigation.code</td><td style="border-left-width: 0px">code</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td style="border-right-width: 0px">ClinicalImpression.investigation.code</td><td style="border-left-width: 0px">ClinicalImpression.investigation.code</td><td>Element `ClinicalImpression.investigation.code` is mapped to FHIR R4 element `ClinicalImpression.investigation.code` as `Equivalent`.</td></tr><tr><td style="border-right-width: 0px">ClinicalImpression.investigation.item</td><td style="border-left-width: 0px">item</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td style="border-right-width: 0px">ClinicalImpression.investigation.item</td><td style="border-left-width: 0px">ClinicalImpression.investigation.item</td><td>Element `ClinicalImpression.investigation.item` is mapped to FHIR R4 element `ClinicalImpression.investigation.item` as `Equivalent`.
Most investigations are observations of one kind of or another but some other specific types of data collection resources can also be used.</td></tr><tr><td style="border-right-width: 0px">ClinicalImpression.protocol</td><td style="border-left-width: 0px">protocol</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td style="border-right-width: 0px">ClinicalImpression.protocol</td><td style="border-left-width: 0px">ClinicalImpression.protocol</td><td>Element `ClinicalImpression.protocol` is mapped to FHIR R4 element `ClinicalImpression.protocol` as `Equivalent`.</td></tr><tr><td style="border-right-width: 0px">ClinicalImpression.summary</td><td style="border-left-width: 0px">summary</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td style="border-right-width: 0px">ClinicalImpression.summary</td><td style="border-left-width: 0px">ClinicalImpression.summary</td><td>Element `ClinicalImpression.summary` is mapped to FHIR R4 element `ClinicalImpression.summary` as `Equivalent`.</td></tr><tr><td style="border-right-width: 0px">ClinicalImpression.finding</td><td style="border-left-width: 0px">finding</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#wider" title="wider">maps to wider concept</a></td><td style="border-right-width: 0px">ClinicalImpression.finding</td><td style="border-left-width: 0px">ClinicalImpression.finding</td><td>Element `ClinicalImpression.finding` is mapped to FHIR R4 element `ClinicalImpression.finding` as `Equivalent`.</td></tr><tr><td style="border-right-width: 0px; border-bottom-style: none">ClinicalImpression.finding.item[x]</td><td style="border-left-width: 0px; border-bottom-style: none">item[x]</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#relatedto" title="relatedto">is related to</a></td><td style="border-right-width: 0px">ClinicalImpression.finding.itemCodeableConcept</td><td style="border-left-width: 0px">ClinicalImpression.finding.itemCodeableConcept</td><td>Element `ClinicalImpression.finding.item[x]` is mapped to FHIR R4 element `ClinicalImpression.finding.itemCodeableConcept` as `SourceIsBroaderThanTarget`.
Element `ClinicalImpression.finding.item[x]` is mapped to FHIR R4 element `ClinicalImpression.finding.itemReference` as `SourceIsBroaderThanTarget`.</td></tr><tr><td style="border-right-width: 0px; border-top-style: none"/><td style="border-top-style: none; border-left-width: 0px"/><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#relatedto" title="relatedto">is related to</a></td><td style="border-right-width: 0px">ClinicalImpression.finding.itemReference</td><td style="border-left-width: 0px">ClinicalImpression.finding.itemReference</td><td>Element `ClinicalImpression.finding.item[x]` is mapped to FHIR R4 element `ClinicalImpression.finding.itemCodeableConcept` as `SourceIsBroaderThanTarget`.
Element `ClinicalImpression.finding.item[x]` is mapped to FHIR R4 element `ClinicalImpression.finding.itemReference` as `SourceIsBroaderThanTarget`.</td></tr><tr><td style="border-right-width: 0px">ClinicalImpression.finding.basis</td><td style="border-left-width: 0px">basis</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td style="border-right-width: 0px">ClinicalImpression.finding.basis</td><td style="border-left-width: 0px">ClinicalImpression.finding.basis</td><td>Element `ClinicalImpression.finding.basis` is mapped to FHIR R4 element `ClinicalImpression.finding.basis` as `Equivalent`.</td></tr><tr><td style="border-right-width: 0px">ClinicalImpression.prognosisCodeableConcept</td><td style="border-left-width: 0px">prognosisCodeableConcept</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td style="border-right-width: 0px">ClinicalImpression.prognosisCodeableConcept</td><td style="border-left-width: 0px">ClinicalImpression.prognosisCodeableConcept</td><td>Element `ClinicalImpression.prognosisCodeableConcept` is mapped to FHIR R4 element `ClinicalImpression.prognosisCodeableConcept` as `Equivalent`.</td></tr><tr><td style="border-right-width: 0px">ClinicalImpression.prognosisReference</td><td style="border-left-width: 0px">prognosisReference</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td style="border-right-width: 0px">ClinicalImpression.prognosisReference</td><td style="border-left-width: 0px">ClinicalImpression.prognosisReference</td><td>Element `ClinicalImpression.prognosisReference` is mapped to FHIR R4 element `ClinicalImpression.prognosisReference` as `Equivalent`.</td></tr><tr><td style="border-right-width: 0px">ClinicalImpression.note</td><td style="border-left-width: 0px">note</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td style="border-right-width: 0px">ClinicalImpression.note</td><td style="border-left-width: 0px">ClinicalImpression.note</td><td>Element `ClinicalImpression.note` is mapped to FHIR R4 element `ClinicalImpression.note` as `Equivalent`.
Don't use this element for content that should more properly appear as one of the specific elements of the impression.</td></tr></table><hr/><p><b>Group 2 </b>Mapping from <code>http://hl7.org/fhir/StructureDefinition/ClinicalImpression|3.0.2</code> to <a href="StructureDefinition-ext-R3-ClinicalImpression.action.html">STU3: Action taken as part of assessment procedure (new)version: 0.1.0)</a></p><table class="grid"><tr><td><b>Source Code</b></td><td><b>Relationship</b></td><td><b>Target Code</b></td><td><b>Comment</b></td></tr><tr><td>ClinicalImpression.action (action)</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td>Extension (STU3: Action taken as part of assessment procedure (new))</td><td>Element `ClinicalImpression.action` has a context of ClinicalImpression based on following the parent source element upwards and mapping to `ClinicalImpression`.
Element `ClinicalImpression.action` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).
Actions recommended as a result of the impression should not be captured using the 'action' element.</td></tr></table></div>
</text>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
<valueCode value="fhir"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
<valueInteger value="0">
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
<valueCanonical
value="http://hl7.org/fhir/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r3.r4"/>
</extension>
</valueInteger>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
<valueCode value="trial-use">
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
<valueCanonical
value="http://hl7.org/fhir/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r3.r4"/>
</extension>
</valueCode>
</extension>
<url
value="http://hl7.org/fhir/uv/xver/ConceptMap/R3-ClinicalImpression-element-map-to-R4"/>
<version value="0.1.0"/>
<name value="R3ClinicalImpressionElementMapToR4"/>
<title
value="Cross-version mapping for FHIR STU3 ClinicalImpression to FHIR R4 ClinicalImpression"/>
<status value="active"/>
<experimental value="false"/>
<date value="2026-03-17T16:03:23.2736426-05:00"/>
<contact>
<name value="FHIR Infrastructure"/>
<telecom>
<system value="url"/>
<value value="http://www.hl7.org/Special/committees/fiwg"/>
</telecom>
</contact>
<description
value="This ConceptMap represents cross-version mappings for elements from a FHIR STU3 ClinicalImpression to FHIR R4."/>
<jurisdiction>
<coding>
<system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
<code value="001"/>
<display value="World"/>
</coding>
</jurisdiction>
<sourceCanonical value="http://hl7.org/fhir/3.0"/>
<targetUri value="http://hl7.org/fhir/4.0"/>
<group>
<source
value="http://hl7.org/fhir/StructureDefinition/ClinicalImpression"/>
<sourceVersion value="3.0.2"/>
<target
value="http://hl7.org/fhir/StructureDefinition/ClinicalImpression"/>
<targetVersion value="4.0.1"/>
<element>
<code value="ClinicalImpression.meta"/>
<display value="meta"/>
<target>
<code value="ClinicalImpression.meta"/>
<display value="ClinicalImpression.meta"/>
<equivalence value="equivalent"/>
<comment
value="Element `ClinicalImpression.meta` is mapped to FHIR R4 element `ClinicalImpression.meta` as `Equivalent`."/>
</target>
</element>
<element>
<code value="ClinicalImpression.implicitRules"/>
<display value="implicitRules"/>
<target>
<code value="ClinicalImpression.implicitRules"/>
<display value="ClinicalImpression.implicitRules"/>
<equivalence value="equivalent"/>
<comment
value="Element `ClinicalImpression.implicitRules` is mapped to FHIR R4 element `ClinicalImpression.implicitRules` as `Equivalent`.
Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.
This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation."/>
</target>
</element>
<element>
<code value="ClinicalImpression.language"/>
<display value="language"/>
<target>
<code value="ClinicalImpression.language"/>
<display value="ClinicalImpression.language"/>
<equivalence value="equivalent"/>
<comment
value="Element `ClinicalImpression.language` is mapped to FHIR R4 element `ClinicalImpression.language` as `Equivalent`.
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)."/>
</target>
</element>
<element>
<code value="ClinicalImpression.text"/>
<display value="text"/>
<target>
<code value="ClinicalImpression.text"/>
<display value="ClinicalImpression.text"/>
<equivalence value="equivalent"/>
<comment
value="Element `ClinicalImpression.text` is mapped to FHIR R4 element `ClinicalImpression.text` as `Equivalent`.
Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later."/>
</target>
</element>
<element>
<code value="ClinicalImpression.contained"/>
<display value="contained"/>
<target>
<code value="ClinicalImpression.contained"/>
<display value="ClinicalImpression.contained"/>
<equivalence value="equivalent"/>
<comment
value="Element `ClinicalImpression.contained` is mapped to FHIR R4 element `ClinicalImpression.contained` as `Equivalent`.
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."/>
</target>
</element>
<element>
<code value="ClinicalImpression.identifier"/>
<display value="identifier"/>
<target>
<code value="ClinicalImpression.identifier"/>
<display value="ClinicalImpression.identifier"/>
<equivalence value="equivalent"/>
<comment
value="Element `ClinicalImpression.identifier` is mapped to FHIR R4 element `ClinicalImpression.identifier` as `Equivalent`."/>
</target>
</element>
<element>
<code value="ClinicalImpression.status"/>
<display value="status"/>
<target>
<code value="ClinicalImpression.status"/>
<display value="ClinicalImpression.status"/>
<equivalence value="equivalent"/>
<comment
value="Element `ClinicalImpression.status` is mapped to FHIR R4 element `ClinicalImpression.status` as `Equivalent`.
This element is labeled as a modifier because the status contains the code entered-in-error that marks the clinical impression as not currently valid."/>
</target>
</element>
<element>
<code value="ClinicalImpression.code"/>
<display value="code"/>
<target>
<code value="ClinicalImpression.code"/>
<display value="ClinicalImpression.code"/>
<equivalence value="equivalent"/>
<comment
value="Element `ClinicalImpression.code` is mapped to FHIR R4 element `ClinicalImpression.code` as `Equivalent`.
This is present as a place-holder only and may be removed based on feedback/work group opinion."/>
</target>
</element>
<element>
<code value="ClinicalImpression.description"/>
<display value="description"/>
<target>
<code value="ClinicalImpression.description"/>
<display value="ClinicalImpression.description"/>
<equivalence value="equivalent"/>
<comment
value="Element `ClinicalImpression.description` is mapped to FHIR R4 element `ClinicalImpression.description` as `Equivalent`."/>
</target>
</element>
<element>
<code value="ClinicalImpression.subject"/>
<display value="subject"/>
<target>
<code value="ClinicalImpression.subject"/>
<display value="ClinicalImpression.subject"/>
<equivalence value="equivalent"/>
<comment
value="Element `ClinicalImpression.subject` is mapped to FHIR R4 element `ClinicalImpression.subject` as `Equivalent`."/>
</target>
</element>
<element>
<code value="ClinicalImpression.context"/>
<display value="context"/>
<target>
<code value="ClinicalImpression.encounter"/>
<display value="ClinicalImpression.encounter"/>
<equivalence value="wider"/>
<comment
value="Element `ClinicalImpression.context` is mapped to FHIR R4 element `ClinicalImpression.encounter` as `SourceIsBroaderThanTarget`.
The mappings for `ClinicalImpression.context` do not cover the following types based on type expansion: display, identifier, reference.
The standard extension `alternate-reference` has been mapped as the representation of FHIR STU3 element `ClinicalImpression.context` with unmapped reference targets: EpisodeOfCare."/>
</target>
</element>
<element>
<code value="ClinicalImpression.effective[x]"/>
<display value="effective[x]"/>
<target>
<code value="ClinicalImpression.effective[x]"/>
<display value="ClinicalImpression.effective[x]"/>
<equivalence value="equivalent"/>
<comment
value="Element `ClinicalImpression.effective[x]` is mapped to FHIR R4 element `ClinicalImpression.effective[x]` as `Equivalent`.
The target context `ClinicalImpression.effective[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `ClinicalImpression`.
This SHOULD be accurate to at least the minute, though some assessments only have a known date."/>
</target>
</element>
<element>
<code value="ClinicalImpression.date"/>
<display value="date"/>
<target>
<code value="ClinicalImpression.date"/>
<display value="ClinicalImpression.date"/>
<equivalence value="equivalent"/>
<comment
value="Element `ClinicalImpression.date` is mapped to FHIR R4 element `ClinicalImpression.date` as `Equivalent`."/>
</target>
</element>
<element>
<code value="ClinicalImpression.assessor"/>
<display value="assessor"/>
<target>
<code value="ClinicalImpression.assessor"/>
<display value="ClinicalImpression.assessor"/>
<equivalence value="equivalent"/>
<comment
value="Element `ClinicalImpression.assessor` is mapped to FHIR R4 element `ClinicalImpression.assessor` as `Equivalent`."/>
</target>
</element>
<element>
<code value="ClinicalImpression.previous"/>
<display value="previous"/>
<target>
<code value="ClinicalImpression.previous"/>
<display value="ClinicalImpression.previous"/>
<equivalence value="equivalent"/>
<comment
value="Element `ClinicalImpression.previous` is mapped to FHIR R4 element `ClinicalImpression.previous` as `Equivalent`.
It is always likely that multiple previous assessments exist for a patient. The point of quoting a previous assessment is that this assessment is relative to it (see resolved)."/>
</target>
</element>
<element>
<code value="ClinicalImpression.problem"/>
<display value="problem"/>
<target>
<code value="ClinicalImpression.problem"/>
<display value="ClinicalImpression.problem"/>
<equivalence value="equivalent"/>
<comment
value="Element `ClinicalImpression.problem` is mapped to FHIR R4 element `ClinicalImpression.problem` as `Equivalent`.
e.g. The patient is a pregnant, and cardiac congestive failure, ‎Adenocarcinoma, and is allergic to penicillin."/>
</target>
</element>
<element>
<code value="ClinicalImpression.investigation"/>
<display value="investigation"/>
<target>
<code value="ClinicalImpression.investigation"/>
<display value="ClinicalImpression.investigation"/>
<equivalence value="wider"/>
<comment
value="Element `ClinicalImpression.investigation` is mapped to FHIR R4 element `ClinicalImpression.investigation` as `Equivalent`."/>
</target>
</element>
<element>
<code value="ClinicalImpression.investigation.code"/>
<display value="code"/>
<target>
<code value="ClinicalImpression.investigation.code"/>
<display value="ClinicalImpression.investigation.code"/>
<equivalence value="equivalent"/>
<comment
value="Element `ClinicalImpression.investigation.code` is mapped to FHIR R4 element `ClinicalImpression.investigation.code` as `Equivalent`."/>
</target>
</element>
<element>
<code value="ClinicalImpression.investigation.item"/>
<display value="item"/>
<target>
<code value="ClinicalImpression.investigation.item"/>
<display value="ClinicalImpression.investigation.item"/>
<equivalence value="equivalent"/>
<comment
value="Element `ClinicalImpression.investigation.item` is mapped to FHIR R4 element `ClinicalImpression.investigation.item` as `Equivalent`.
Most investigations are observations of one kind of or another but some other specific types of data collection resources can also be used."/>
</target>
</element>
<element>
<code value="ClinicalImpression.protocol"/>
<display value="protocol"/>
<target>
<code value="ClinicalImpression.protocol"/>
<display value="ClinicalImpression.protocol"/>
<equivalence value="equivalent"/>
<comment
value="Element `ClinicalImpression.protocol` is mapped to FHIR R4 element `ClinicalImpression.protocol` as `Equivalent`."/>
</target>
</element>
<element>
<code value="ClinicalImpression.summary"/>
<display value="summary"/>
<target>
<code value="ClinicalImpression.summary"/>
<display value="ClinicalImpression.summary"/>
<equivalence value="equivalent"/>
<comment
value="Element `ClinicalImpression.summary` is mapped to FHIR R4 element `ClinicalImpression.summary` as `Equivalent`."/>
</target>
</element>
<element>
<code value="ClinicalImpression.finding"/>
<display value="finding"/>
<target>
<code value="ClinicalImpression.finding"/>
<display value="ClinicalImpression.finding"/>
<equivalence value="wider"/>
<comment
value="Element `ClinicalImpression.finding` is mapped to FHIR R4 element `ClinicalImpression.finding` as `Equivalent`."/>
</target>
</element>
<element>
<code value="ClinicalImpression.finding.item[x]"/>
<display value="item[x]"/>
<target>
<code value="ClinicalImpression.finding.itemCodeableConcept"/>
<display value="ClinicalImpression.finding.itemCodeableConcept"/>
<equivalence value="relatedto"/>
<comment
value="Element `ClinicalImpression.finding.item[x]` is mapped to FHIR R4 element `ClinicalImpression.finding.itemCodeableConcept` as `SourceIsBroaderThanTarget`.
Element `ClinicalImpression.finding.item[x]` is mapped to FHIR R4 element `ClinicalImpression.finding.itemReference` as `SourceIsBroaderThanTarget`."/>
</target>
<target>
<code value="ClinicalImpression.finding.itemReference"/>
<display value="ClinicalImpression.finding.itemReference"/>
<equivalence value="relatedto"/>
<comment
value="Element `ClinicalImpression.finding.item[x]` is mapped to FHIR R4 element `ClinicalImpression.finding.itemCodeableConcept` as `SourceIsBroaderThanTarget`.
Element `ClinicalImpression.finding.item[x]` is mapped to FHIR R4 element `ClinicalImpression.finding.itemReference` as `SourceIsBroaderThanTarget`."/>
</target>
</element>
<element>
<code value="ClinicalImpression.finding.basis"/>
<display value="basis"/>
<target>
<code value="ClinicalImpression.finding.basis"/>
<display value="ClinicalImpression.finding.basis"/>
<equivalence value="equivalent"/>
<comment
value="Element `ClinicalImpression.finding.basis` is mapped to FHIR R4 element `ClinicalImpression.finding.basis` as `Equivalent`."/>
</target>
</element>
<element>
<code value="ClinicalImpression.prognosisCodeableConcept"/>
<display value="prognosisCodeableConcept"/>
<target>
<code value="ClinicalImpression.prognosisCodeableConcept"/>
<display value="ClinicalImpression.prognosisCodeableConcept"/>
<equivalence value="equivalent"/>
<comment
value="Element `ClinicalImpression.prognosisCodeableConcept` is mapped to FHIR R4 element `ClinicalImpression.prognosisCodeableConcept` as `Equivalent`."/>
</target>
</element>
<element>
<code value="ClinicalImpression.prognosisReference"/>
<display value="prognosisReference"/>
<target>
<code value="ClinicalImpression.prognosisReference"/>
<display value="ClinicalImpression.prognosisReference"/>
<equivalence value="equivalent"/>
<comment
value="Element `ClinicalImpression.prognosisReference` is mapped to FHIR R4 element `ClinicalImpression.prognosisReference` as `Equivalent`."/>
</target>
</element>
<element>
<code value="ClinicalImpression.note"/>
<display value="note"/>
<target>
<code value="ClinicalImpression.note"/>
<display value="ClinicalImpression.note"/>
<equivalence value="equivalent"/>
<comment
value="Element `ClinicalImpression.note` is mapped to FHIR R4 element `ClinicalImpression.note` as `Equivalent`.
Don't use this element for content that should more properly appear as one of the specific elements of the impression."/>
</target>
</element>
</group>
<group>
<source
value="http://hl7.org/fhir/StructureDefinition/ClinicalImpression"/>
<sourceVersion value="3.0.2"/>
<target
value="http://hl7.org/fhir/3.0/StructureDefinition/extension-ClinicalImpression.action"/>
<targetVersion value="0.1.0"/>
<element>
<code value="ClinicalImpression.action"/>
<display value="action"/>
<target>
<code value="Extension"/>
<equivalence value="equivalent"/>
<comment
value="Element `ClinicalImpression.action` has a context of ClinicalImpression based on following the parent source element upwards and mapping to `ClinicalImpression`.
Element `ClinicalImpression.action` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).
Actions recommended as a result of the impression should not be captured using the 'action' element."/>
</target>
</element>
</group>
</ConceptMap>
IG © 2025+ FHIR Infrastructure. Package hl7.fhir.uv.xver-r3.r4#0.1.0 based on FHIR 4.0.1. Generated 2026-03-20
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