Generated Narrative: ConceptMap R4-Composition-element-map-to-R4B Mapping from http://hl7.org/fhir/4.0 to http://hl7.org/fhir/4.3 Group 1 Mapping from http://hl7.org/fhir/StructureDefinition/Composition|4.0.1 to Compositionversion: 4.3.0) Source Code Relationship Target Code Comment Composition.meta (meta) is equivalent to Composition.meta Element `Composition.meta` is mapped to FHIR R4B element `Composition.meta` as `Equivalent`. Composition.implicitRules (implicitRules) is equivalent to Composition.implicitRules Element `Composition.implicitRules` is mapped to FHIR R4B element `Composition.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. 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. Composition.language (language) is equivalent to Composition.language Element `Composition.language` is mapped to FHIR R4B element `Composition.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). Composition.text (text) is equivalent to Composition.text Element `Composition.text` is mapped to FHIR R4B element `Composition.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 information is added later. Composition.contained (contained) is equivalent to Composition.contained Element `Composition.contained` is mapped to FHIR R4B element `Composition.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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Composition.identifier (identifier) is equivalent to Composition.identifier Element `Composition.identifier` is mapped to FHIR R4B element `Composition.identifier` as `Equivalent`. Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate. Composition.status (status) is equivalent to Composition.status Element `Composition.status` is mapped to FHIR R4B element `Composition.status` as `Equivalent`. 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. Composition.type (type) is equivalent to Composition.type Element `Composition.type` is mapped to FHIR R4B element `Composition.type` as `Equivalent`. 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. Composition.category (category) is equivalent to Composition.category Element `Composition.category` is mapped to FHIR R4B element `Composition.category` as `Equivalent`. This is a metadata field from [XDS/MHD](http://wiki.ihe.net/index.php?title=Mobile_access_to_Health_Documents_(MHD)). Composition.subject (subject) is equivalent to Composition.subject Element `Composition.subject` is mapped to FHIR R4B element `Composition.subject` as `Equivalent`. For clinical documents, this is usually the patient. Composition.encounter (encounter) is equivalent to Composition.encounter Element `Composition.encounter` is mapped to FHIR R4B element `Composition.encounter` as `Equivalent`. Composition.date (date) is equivalent to Composition.date Element `Composition.date` is mapped to FHIR R4B element `Composition.date` as `Equivalent`. The Last Modified Date on the composition may be after the date of the document was attested without being changed. Composition.author (author) is equivalent to Composition.author Element `Composition.author` is mapped to FHIR R4B element `Composition.author` as `Equivalent`. Composition.title (title) is equivalent to Composition.title Element `Composition.title` is mapped to FHIR R4B element `Composition.title` as `Equivalent`. 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. Composition.confidentiality (confidentiality) is equivalent to Composition.confidentiality Element `Composition.confidentiality` is mapped to FHIR R4B element `Composition.confidentiality` as `Equivalent`. 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. Composition.attester (attester) maps to wider concept Composition.attester Element `Composition.attester` is mapped to FHIR R4B element `Composition.attester` as `Equivalent`. Only list each attester once. Composition.attester.mode (mode) is equivalent to Composition.attester.mode Element `Composition.attester.mode` is mapped to FHIR R4B element `Composition.attester.mode` as `Equivalent`. Composition.attester.time (time) is equivalent to Composition.attester.time Element `Composition.attester.time` is mapped to FHIR R4B element `Composition.attester.time` as `Equivalent`. Composition.attester.party (party) is equivalent to Composition.attester.party Element `Composition.attester.party` is mapped to FHIR R4B element `Composition.attester.party` as `Equivalent`. Composition.custodian (custodian) is equivalent to Composition.custodian Element `Composition.custodian` is mapped to FHIR R4B element `Composition.custodian` as `Equivalent`. 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. Composition.relatesTo (relatesTo) maps to wider concept Composition.relatesTo Element `Composition.relatesTo` is mapped to FHIR R4B element `Composition.relatesTo` as `Equivalent`. A document is a version specific composition. Composition.relatesTo.code (code) is equivalent to Composition.relatesTo.code Element `Composition.relatesTo.code` is mapped to FHIR R4B element `Composition.relatesTo.code` as `Equivalent`. If this document appends another document, then the document cannot be fully understood without also accessing the referenced document. Composition.relatesTo.target[x] (target[x]) is equivalent to Composition.relatesTo.target[x] Element `Composition.relatesTo.target[x]` is mapped to FHIR R4B element `Composition.relatesTo.target[x]` as `Equivalent`. The target context `Composition.relatesTo.target[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `Composition.relatesTo`. Composition.event (event) maps to wider concept Composition.event Element `Composition.event` is mapped to FHIR R4B element `Composition.event` as `Equivalent`. The event needs to be consistent with the type element, though can provide further information if desired. Composition.event.code (code) is equivalent to Composition.event.code Element `Composition.event.code` is mapped to FHIR R4B element `Composition.event.code` as `Equivalent`. 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. Composition.event.period (period) is equivalent to Composition.event.period Element `Composition.event.period` is mapped to FHIR R4B element `Composition.event.period` as `Equivalent`. Composition.event.detail (detail) is equivalent to Composition.event.detail Element `Composition.event.detail` is mapped to FHIR R4B element `Composition.event.detail` as `Equivalent`. Composition.section (section) maps to wider concept Composition.section Element `Composition.section` is mapped to FHIR R4B element `Composition.section` as `Equivalent`. Composition.section.title (title) is equivalent to Composition.section.title Element `Composition.section.title` is mapped to FHIR R4B element `Composition.section.title` as `Equivalent`. 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. Composition.section.code (code) is equivalent to Composition.section.code Element `Composition.section.code` is mapped to FHIR R4B element `Composition.section.code` as `Equivalent`. 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. Composition.section.author (author) is equivalent to Composition.section.author Element `Composition.section.author` is mapped to FHIR R4B element `Composition.section.author` as `Equivalent`. Composition.section.focus (focus) is equivalent to Composition.section.focus Element `Composition.section.focus` is mapped to FHIR R4B element `Composition.section.focus` as `Equivalent`. 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. Composition.section.text (text) is equivalent to Composition.section.text Element `Composition.section.text` is mapped to FHIR R4B element `Composition.section.text` as `Equivalent`. Document profiles may define what content should be represented in the narrative to ensure clinical safety. Composition.section.mode (mode) is equivalent to Composition.section.mode Element `Composition.section.mode` is mapped to FHIR R4B element `Composition.section.mode` as `Equivalent`. This element is labeled as a modifier because a change list must not be misunderstood as a complete list. Composition.section.orderedBy (orderedBy) is equivalent to Composition.section.orderedBy Element `Composition.section.orderedBy` is mapped to FHIR R4B element `Composition.section.orderedBy` as `Equivalent`. 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. Composition.section.entry (entry) is equivalent to Composition.section.entry Element `Composition.section.entry` is mapped to FHIR R4B element `Composition.section.entry` as `Equivalent`. If there are no entries in the list, an emptyReason SHOULD be provided. Composition.section.emptyReason (emptyReason) is equivalent to Composition.section.emptyReason Element `Composition.section.emptyReason` is mapped to FHIR R4B element `Composition.section.emptyReason` as `Equivalent`. 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. Composition.section.section (section) is equivalent to Composition.section.section Element `Composition.section.section` is mapped to FHIR R4B element `Composition.section.section` as `Equivalent`. Nested sections are primarily used to help human readers navigate to particular portions of the document.
Cross-version mapping for FHIR R4 Composition to FHIR R4B Composition
This ConceptMap represents cross-version mappings for elements from a FHIR R4 Composition to FHIR R4B.
Element `Composition.meta` is mapped to FHIR R4B element `Composition.meta` as `Equivalent`.
Element `Composition.implicitRules` is mapped to FHIR R4B element `Composition.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. 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.
Element `Composition.language` is mapped to FHIR R4B element `Composition.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).
Element `Composition.text` is mapped to FHIR R4B element `Composition.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 information is added later.
Element `Composition.contained` is mapped to FHIR R4B element `Composition.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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Element `Composition.identifier` is mapped to FHIR R4B element `Composition.identifier` as `Equivalent`. Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate.
Element `Composition.status` is mapped to FHIR R4B element `Composition.status` as `Equivalent`. 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.
Element `Composition.type` is mapped to FHIR R4B element `Composition.type` as `Equivalent`. 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.
Element `Composition.category` is mapped to FHIR R4B element `Composition.category` as `Equivalent`. This is a metadata field from [XDS/MHD](http://wiki.ihe.net/index.php?title=Mobile_access_to_Health_Documents_(MHD)).
Element `Composition.subject` is mapped to FHIR R4B element `Composition.subject` as `Equivalent`. For clinical documents, this is usually the patient.
Element `Composition.encounter` is mapped to FHIR R4B element `Composition.encounter` as `Equivalent`.
Element `Composition.date` is mapped to FHIR R4B element `Composition.date` as `Equivalent`. The Last Modified Date on the composition may be after the date of the document was attested without being changed.
Element `Composition.author` is mapped to FHIR R4B element `Composition.author` as `Equivalent`.
Element `Composition.title` is mapped to FHIR R4B element `Composition.title` as `Equivalent`. 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.
Element `Composition.confidentiality` is mapped to FHIR R4B element `Composition.confidentiality` as `Equivalent`. 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.
Element `Composition.attester` is mapped to FHIR R4B element `Composition.attester` as `Equivalent`. Only list each attester once.
Element `Composition.attester.mode` is mapped to FHIR R4B element `Composition.attester.mode` as `Equivalent`.
Element `Composition.attester.time` is mapped to FHIR R4B element `Composition.attester.time` as `Equivalent`.
Element `Composition.attester.party` is mapped to FHIR R4B element `Composition.attester.party` as `Equivalent`.
Element `Composition.custodian` is mapped to FHIR R4B element `Composition.custodian` as `Equivalent`. 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.
Element `Composition.relatesTo` is mapped to FHIR R4B element `Composition.relatesTo` as `Equivalent`. A document is a version specific composition.
Element `Composition.relatesTo.code` is mapped to FHIR R4B element `Composition.relatesTo.code` as `Equivalent`. If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.
Element `Composition.relatesTo.target[x]` is mapped to FHIR R4B element `Composition.relatesTo.target[x]` as `Equivalent`. The target context `Composition.relatesTo.target[x]` is a choice-type element and cannot directly hold extensions. The context is moved up to parent element `Composition.relatesTo`.
Element `Composition.event` is mapped to FHIR R4B element `Composition.event` as `Equivalent`. The event needs to be consistent with the type element, though can provide further information if desired.
Element `Composition.event.code` is mapped to FHIR R4B element `Composition.event.code` as `Equivalent`. 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.
Element `Composition.event.period` is mapped to FHIR R4B element `Composition.event.period` as `Equivalent`.
Element `Composition.event.detail` is mapped to FHIR R4B element `Composition.event.detail` as `Equivalent`.
Element `Composition.section` is mapped to FHIR R4B element `Composition.section` as `Equivalent`.
Element `Composition.section.title` is mapped to FHIR R4B element `Composition.section.title` as `Equivalent`. 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.
Element `Composition.section.code` is mapped to FHIR R4B element `Composition.section.code` as `Equivalent`. 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.
Element `Composition.section.author` is mapped to FHIR R4B element `Composition.section.author` as `Equivalent`.
Element `Composition.section.focus` is mapped to FHIR R4B element `Composition.section.focus` as `Equivalent`. 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.
Element `Composition.section.text` is mapped to FHIR R4B element `Composition.section.text` as `Equivalent`. Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Element `Composition.section.mode` is mapped to FHIR R4B element `Composition.section.mode` as `Equivalent`. This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Element `Composition.section.orderedBy` is mapped to FHIR R4B element `Composition.section.orderedBy` as `Equivalent`. 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.
Element `Composition.section.entry` is mapped to FHIR R4B element `Composition.section.entry` as `Equivalent`. If there are no entries in the list, an emptyReason SHOULD be provided.
Element `Composition.section.emptyReason` is mapped to FHIR R4B element `Composition.section.emptyReason` as `Equivalent`. 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.
Element `Composition.section.section` is mapped to FHIR R4B element `Composition.section.section` as `Equivalent`. Nested sections are primarily used to help human readers navigate to particular portions of the document.