A curated namespace that issues unique symbols within that namespace for the identification of concepts, people, devices, etc. Represents a "System" used within the Identifier and Coding data types.

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

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.

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

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.

A natural language name identifying the naming system. This name should be usable as an identifier for the module by machine processing applications such as code generation.

The name is not expected to be globally unique. The name should be a simple alpha-numeric type name to ensure that it is computable friendly. The"symbolic name" for an OID would be captured as an extension.

Support human navigation and code generation.

The status of this naming system. Enables tracking the life-cycle of the content.

Allows filtering of naming systems that are appropriate for use vs. not.
This is labeled as "Is Modifier" because applications should not use a retired naming system without due consideration.

The lifecycle status of a Value Set or Concept Map.

Indicates the purpose for the naming system - what kinds of things does it make unique?

Identifies the purpose of the naming system.

The date (and optionally time) when the naming system was published. The date must change if and when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the naming system changes.

Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the naming system. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

Indicates how the system may be identified when referenced in electronic exchange.

Multiple identifiers may exist, either due to duplicate registration, regional rules, needs of different communication technologies, etc.

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

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.

Identifies the unique identifier scheme used for this particular identifier.

Different identifier types may be used in different types of communications (OIDs for v3, URIs for FHIR, etc.). Other includes RUIDs from v3, standard v2 code name strings, etc.

Identifies the style of unique identifier used to identify a namespace.

The string that should be sent over the wire to identify the code system or identifier system.

If the value is a URI intended for use as FHIR system identifier, the URI should not contain "" or "?" or "," since this makes escaping very difficult.

R4B: NamingSystem.meta additional types (Meta) additional types from child elements (lastUpdated, profile, security, source, tag, versionId)

Element NamingSystem.meta is mapped to FHIR STU3 element NamingSystem.meta as SourceIsBroaderThanTarget. The mappings for NamingSystem.meta do not cover the following types: Meta. The mappings for NamingSystem.meta do not cover the following types based on type expansion: lastUpdated, profile, security, source, tag, versionId.

R4B: NamingSystem.text additional types (Narrative) additional types from child elements (div, status)

Element NamingSystem.text is mapped to FHIR STU3 element NamingSystem.text as SourceIsBroaderThanTarget. The mappings for NamingSystem.text do not cover the following types: Narrative. The mappings for NamingSystem.text do not cover the following types based on type expansion: div, status. 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.

R4B: NamingSystem.contact additional types (ContactDetail) additional types from child elements (name, telecom)

Element NamingSystem.contact is mapped to FHIR STU3 element NamingSystem.contact as SourceIsBroaderThanTarget. The mappings for NamingSystem.contact do not cover the following types: ContactDetail. The mappings for NamingSystem.contact do not cover the following types based on type expansion: name, telecom. May be a web site, an email address, a telephone number, etc.

R4B: NamingSystem.useContext additional types (UsageContext) additional types from child elements (code, value[x])

Element NamingSystem.useContext is mapped to FHIR STU3 element NamingSystem.useContext as SourceIsBroaderThanTarget. The mappings for NamingSystem.useContext do not cover the following types: UsageContext. The mappings for NamingSystem.useContext do not cover the following types based on type expansion: code, value[x]. When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.

R4B: NamingSystem.uniqueId.period additional types (Period) additional types from child elements (end, start)

Element NamingSystem.uniqueId.period is mapped to FHIR STU3 element NamingSystem.uniqueId.period as SourceIsBroaderThanTarget. The mappings for NamingSystem.uniqueId.period do not cover the following types: Period. The mappings for NamingSystem.uniqueId.period do not cover the following types based on type expansion: end, start. Within a registry, a given identifier should only be "active" for a single namespace at a time. (Ideally, an identifier should only ever be associated with a single namespace across all time).

A curated namespace that issues unique symbols within that namespace for the identification of concepts, people, devices, etc. Represents a "System" used within the Identifier and Coding data types.

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

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

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

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

An Extension

R4B: NamingSystem.meta additional types (Meta) additional types from child elements (lastUpdated, profile, security, source, tag, versionId)

Element NamingSystem.meta is mapped to FHIR STU3 element NamingSystem.meta as SourceIsBroaderThanTarget. The mappings for NamingSystem.meta do not cover the following types: Meta. The mappings for NamingSystem.meta do not cover the following types based on type expansion: lastUpdated, profile, security, source, tag, versionId.

The version specific identifier, as it appears in the version portion of the URL. This values changes when the resource is created, updated, or deleted.

The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

When the resource last changed - e.g. when the version changed.

This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant.

A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

The security labels can be updated without changing the stated version of the resource The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

Security Labels from the Healthcare Privacy and Security Classification System.

Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

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.

The base language in which the resource is written.

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).

A human language.

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

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.

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

An Extension

R4B: NamingSystem.text additional types (Narrative) additional types from child elements (div, status)

Element NamingSystem.text is mapped to FHIR STU3 element NamingSystem.text as SourceIsBroaderThanTarget. The mappings for NamingSystem.text do not cover the following types: Narrative. The mappings for NamingSystem.text do not cover the following types based on type expansion: div, status. 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.

The status of the narrative - whether it's entirely generated (from just the defined data or the extensions too), or whether a human authored it and it may contain additional data.

The status of a resource narrative

The actual narrative content, a stripped down version of XHTML.

The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained stylesheets. The XHTML content may not contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.

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.

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.

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

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.

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

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.

A natural language name identifying the naming system. This name should be usable as an identifier for the module by machine processing applications such as code generation.

The name is not expected to be globally unique. The name should be a simple alpha-numeric type name to ensure that it is computable friendly. The"symbolic name" for an OID would be captured as an extension.

Support human navigation and code generation.

The status of this naming system. Enables tracking the life-cycle of the content.

Allows filtering of naming systems that are appropriate for use vs. not.
This is labeled as "Is Modifier" because applications should not use a retired naming system without due consideration.

The lifecycle status of a Value Set or Concept Map.

Indicates the purpose for the naming system - what kinds of things does it make unique?

Identifies the purpose of the naming system.

The date (and optionally time) when the naming system was published. The date must change if and when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the naming system changes.

Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the naming system. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

The name of the individual or organization that published the naming system.

Usually an organization, but may be an individual. The publisher (or steward) of the naming system is the organization or individual primarily responsible for the maintenance and upkeep of the naming system. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the naming system. This item SHOULD be populated unless the information is available from context.

Helps establish the "authority/credibility" of the naming system. May also allow for contact.

Contact details to assist a user in finding and communicating with the publisher.

May be a web site, an email address, a telephone number, etc.

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

An Extension

R4B: NamingSystem.contact additional types (ContactDetail) additional types from child elements (name, telecom)

Element NamingSystem.contact is mapped to FHIR STU3 element NamingSystem.contact as SourceIsBroaderThanTarget. The mappings for NamingSystem.contact do not cover the following types: ContactDetail. The mappings for NamingSystem.contact do not cover the following types based on type expansion: name, telecom. May be a web site, an email address, a telephone number, etc.

The name of an individual to contact.

If there is no named individual, the telecom information is for the organization as a whole.

The contact details for the individual (if a name was provided) or the organization.

The name of the organization that is responsible for issuing identifiers or codes for this namespace and ensuring their non-collision.

This is the primary organization. Responsibility for some aspects of a namespace may be delegated.

Categorizes a naming system for easier search by grouping related naming systems.

This will most commonly be used for identifier namespaces, but categories could potentially be useful for code systems and authorities as well.

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

A free text natural language description of the naming system from a consumer's perspective. Details about what the namespace identifies including scope, granularity, version labeling, etc.

This description can be used to capture details such as why the naming system was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the naming system as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the profile is presumed to be the predominant language in the place the profile was created).

The content was developed with a focus and intent of supporting the contexts that are listed. These terms may be used to assist with indexing and searching for appropriate naming system instances.

When multiple useContexts are specified, there is no expectation whether all or any of the contexts apply.

Assist in searching for appropriate content.

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

An Extension

R4B: NamingSystem.useContext additional types (UsageContext) additional types from child elements (code, value[x])

Element NamingSystem.useContext is mapped to FHIR STU3 element NamingSystem.useContext as SourceIsBroaderThanTarget. The mappings for NamingSystem.useContext do not cover the following types: UsageContext. The mappings for NamingSystem.useContext do not cover the following types based on type expansion: code, value[x]. When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.

A code that identifies the type of context being specified by this usage context.

A code that specifies a type of context being specified by a usage context

A value that defines the context specified in this context of use. The interpretation of the value is defined by the code.

A code that defines the specific value for the context being specified

A legal or geographic region in which the naming system is intended to be used.

It may be possible for the naming system to be used in jurisdictions other than those for which it was originally designed or intended.

Countries and regions within which this artifact is targeted for use

Provides guidance on the use of the namespace, including the handling of formatting characters, use of upper vs. lower case, etc.

Indicates how the system may be identified when referenced in electronic exchange.

Multiple identifiers may exist, either due to duplicate registration, regional rules, needs of different communication technologies, etc.

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

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

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.

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

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.

Identifies the unique identifier scheme used for this particular identifier.

Different identifier types may be used in different types of communications (OIDs for v3, URIs for FHIR, etc.). Other includes RUIDs from v3, standard v2 code name strings, etc.

Identifies the style of unique identifier used to identify a namespace.

The string that should be sent over the wire to identify the code system or identifier system.

If the value is a URI intended for use as FHIR system identifier, the URI should not contain "" or "?" or "," since this makes escaping very difficult.

Indicates whether this identifier is the "preferred" identifier of this type.

Notes about the past or intended usage of this identifier.

e.g. "must be used in Germany" or "was initially published in error with this value".

Identifies the period of time over which this identifier is considered appropriate to refer to the naming system. Outside of this window, the identifier might be non-deterministic.

Within a registry, a given identifier should only be "active" for a single namespace at a time. (Ideally, an identifier should only ever be associated with a single namespace across all time).

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

An Extension

R4B: NamingSystem.uniqueId.period additional types (Period) additional types from child elements (end, start)

Element NamingSystem.uniqueId.period is mapped to FHIR STU3 element NamingSystem.uniqueId.period as SourceIsBroaderThanTarget. The mappings for NamingSystem.uniqueId.period do not cover the following types: Period. The mappings for NamingSystem.uniqueId.period do not cover the following types based on type expansion: end, start. Within a registry, a given identifier should only be "active" for a single namespace at a time. (Ideally, an identifier should only ever be associated with a single namespace across all time).

The start of the period. The boundary is inclusive.

If the low element is missing, the meaning is that the low boundary is not known.

The end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.

For naming systems that are retired, indicates the naming system that should be used in their place (if any).