This page is part of the FHIR Specification (v0.0.82: DSTU 1). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions

Xds-profile.profile.xml

Profile for Specific XDS profile for the general document reference functionality

{
  "resourceType": "Profile",
  "text": {
    "status": "generated",
    "div": "<div><pre> <span style=\"float: right\"><a title=\"Documentation for this format\" href=\"formats.html\"><img alt=\"doco\" src=\"help.png\"/></a></span>\r\n<span style=\"color: Gray\">&lt;!-- <span style=\"color: Darkviolet\">Resources</span> --&gt;</span>\r\n<span style=\"color: Gray\">&lt;!--<a name=\"DocumentReference\"> </a><span style=\"color: Darkviolet\">DocumentReference</span> --&gt;</span>\r\n&lt;<span title=\"A reference to a document.\"><b>DocumentReference</b></span> xmlns=&quot;http://hl7.org/fhir&quot;&gt;\r\n &lt;!-- from Element: <a href=\"extensibility.html\">extension</a> --&gt;\r\n <i class=\"inherited\">&lt;<span title=\"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 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.\"><b>extension</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>0..*</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/extensibility.html#Extension\">Extension</a></span> <span style=\"color: navy\">Additional Content defined by implementations</span><span style=\"color: Gray\"> --&gt;</span>&lt;/extension&gt;</i>\r\n <i class=\"inherited\">&lt;<span title=\"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 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.\"><b>modifierExtension</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>0..*</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/extensibility.html#Extension\">Extension</a></span> <span style=\"color: navy\">Extensions that cannot be ignored</span><span style=\"color: Gray\"> --&gt;</span>&lt;/modifierExtension&gt;</i>\r\n <i class=\"inherited\">&lt;<span title=\"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 &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.\"><b>text</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>0..1</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/narrative.html#Narrative\">Narrative</a></span> <span style=\"color: navy\">Text summary of the resource, for human interpretation</span><span style=\"color: Gray\"> --&gt;</span>&lt;/text&gt;</i>\r\n <i class=\"inherited\">&lt;<span title=\"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.\"><b>contained</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>0..*</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/references.html#Resource\">Resource</a></span> <span style=\"color: navy\">Contained, inline Resources</span><span style=\"color: Gray\"> --&gt;</span>&lt;/contained&gt;</i>\r\n &lt;<span title=\"Globally unique identifier assigned to the document by the creating entity.\nA DocumentEntry representing a single document is identified by the uniqueId attribute; the linkage between DocumentEntry and the Document it represents is made with the uniqueId attribute.\nThis unique identifier may be used in other documents to reference this document.\"><b>masterIdentifier</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>1..1</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/datatypes.html#Identifier\">Identifier</a></span> <span style=\"color: navy\">XDSDocumentEntry.uniqueId</span><span style=\"color: Gray\"> --&gt;</span>&lt;/masterIdentifier&gt;\r\n &lt;<span title=\"Other identifiers for the document.\"><b>identifier</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>0..*</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/datatypes.html#Identifier\">Identifier</a></span> <span style=\"color: navy\">XDSDocumentEntry.referenceIdList</span><span style=\"color: Gray\"> --&gt;</span>&lt;/identifier&gt;\r\n &lt;<span title=\"The patientId represents the subject of care of the document.  The value of the patientId shall be the same for all new documents of a SubmissionSet. Patient information typically includes: the patient first and last name, sex, and birth date.\"><b>subject</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>1..1</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/references.html#Resource\">Resource</a>(<a href=\"http://hl7.org/fhir/patient.html#Patient\">Patient</a>)</span> <span style=\"color: navy\">\r\n     XDSDocumentEntry.patientId + sourcePatientId/sourcePatientInfo</span><span style=\"color: Gray\"> --&gt;</span>&lt;/subject&gt;\r\n &lt;<span title=\"The code specifying the particular kind of document (e.g., Prescription, Discharge Summary, Report). It is suggested that the XDS Affinity Domain draws these values from a coding scheme providing a coarse level of granularity (about 10 to 100 entries). Shall have a single value.\"><b>type</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>1..1</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/datatypes.html#CodeableConcept\">CodeableConcept</a></span> <span style=\"color: navy\"><a style=\"color: navy\" href=\"valueset-doc-codes.html\">XDSDocumentEntry.typeCode</a></span><span style=\"color: Gray\"> --&gt;</span>&lt;/type&gt;\r\n &lt;<span title=\"A categorization for the type of the document. This may be implied by or derived from the code specified in the Document Type.\"><b>class</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>1..1</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/datatypes.html#CodeableConcept\">CodeableConcept</a></span> <span style=\"color: navy\"><a style=\"color: navy\" href=\"valueset-xds-typecodes.html\">XDSDocumentEntry.classCode</a></span><span style=\"color: Gray\"> --&gt;</span>&lt;/class&gt;\r\n &lt;<span title=\"Represents the humans and/or machines that authored the document.\"><b>author</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>1..*</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/references.html#Resource\">Resource</a>(<a href=\"http://hl7.org/fhir/practitioner.html#Practitioner\">Practitioner</a>|<a href=\"http://hl7.org/fhir/device.html#Device\">Device</a>)</span> <span style=\"color: navy\">XDSDocumentEntry.author</span><span style=\"color: Gray\"> --&gt;</span>&lt;/author&gt;\r\n &lt;<span title=\"Org which maintains the document.\"><b>custodian</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>0..0</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/references.html#Resource\">Resource</a>(<a href=\"http://hl7.org/fhir/organization.html#Organization\">Organization</a>)</span> <span style=\"text-decoration: line-through\"><span style=\"color: navy\">n/a</span></span><span style=\"color: Gray\"> --&gt;</span>&lt;/custodian&gt;\r\n &lt;<span title=\"A globally unique identifier for a community with which this document is associated.\"><b>policyManager</b></span> value=&quot;[<span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/datatypes.html#uri\">uri</a></span>]&quot;/&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>0..1</b></span> <span style=\"color: navy\">XDSDocumentEntry.homeCommunityId</span><span style=\"color: Gray\"> --&gt;</span>\r\n &lt;<span title=\"Represents a participant who has legally authenticated or attested the document within the authorInstitution. Legal authentication implies that a document has been signed manually or electronically by the legalAuthenticator.\"><b>authenticator</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>0..1</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/references.html#Resource\">Resource</a>(<a href=\"http://hl7.org/fhir/practitioner.html#Practitioner\">Practitioner</a>)</span> <span style=\"color: navy\">??</span><span style=\"color: Gray\"> --&gt;</span>&lt;/authenticator&gt;\r\n &lt;<span title=\"Represents the time the author created the document in the Document Source.\"><b>created</b></span> value=&quot;[<span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/datatypes.html#dateTime\">dateTime</a></span>]&quot;/&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>1..1</b></span> <span style=\"color: navy\">XDSDocumentEntry.creationTime</span><span style=\"color: Gray\"> --&gt;</span>\r\n &lt;<span title=\"When this document reference created.\"><b>indexed</b></span> value=&quot;[<span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/datatypes.html#instant\">instant</a></span>]&quot;/&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>1..1</b></span> <span style=\"color: navy\">XDS submission time or XDSDocumentEntry.creationTime  if unknown</span><span style=\"color: Gray\"> --&gt;</span>\r\n &lt;<span title=\"This attribute is always set to Approved as part of the submission of new XDS Documents. It may be changed to Deprecated under the primary responsibility of the Document Source with possible patient supervision. Although XDS supports the ability to delete documents, there is no such state as “the Document Entry is removed” (only an audit trail is kept if such a deletion is allowed).\"><b>status</b></span> value=&quot;[<span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/datatypes.html#code\">code</a></span>]&quot;/&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>1..1</b></span> <span style=\"color: navy\"><a style=\"color: navy\" href=\"document-reference-status.html\">implied by XDS workflow</a></span><span style=\"color: Gray\"> --&gt;</span>\r\n &lt;<span title=\"Status of the underlying document.\"><b>docStatus</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>0..0</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/datatypes.html#CodeableConcept\">CodeableConcept</a></span> <span style=\"text-decoration: line-through\"><a style=\"color: navy\" href=\"composition-status.html\">preliminary | final | appended | amended | entered in error</a></span><span style=\"color: Gray\"> --&gt;</span>&lt;/docStatus&gt;\r\n &lt;<span title=\"Relationships to other documents.\"><b>relatesTo</b></span>&gt;  <span style=\"color: Gray\">&lt;!-- <span style=\"color: brown\"><b>0..*</b></span> Relationships that this document has with other document references that already exist --&gt;</span>\r\n  <i class=\"inherited\">&lt;<span title=\"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 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.\"><b>extension</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>0..*</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/extensibility.html#Extension\">Extension</a></span> <span style=\"color: navy\">Additional Content defined by implementations</span><span style=\"color: Gray\"> --&gt;</span>&lt;/extension&gt;</i>\r\n  <i class=\"inherited\">&lt;<span title=\"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 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.\"><b>modifierExtension</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>0..*</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/extensibility.html#Extension\">Extension</a></span> <span style=\"color: navy\">Extensions that cannot be ignored</span><span style=\"color: Gray\"> --&gt;</span>&lt;/modifierExtension&gt;</i>\r\n  &lt;<span title=\"supercedes | transforms | signs | appends.\"><b>code</b></span> value=&quot;[<span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/datatypes.html#code\">code</a></span>]&quot;/&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>1..1</b></span> <span style=\"color: navy\"><a style=\"color: navy\" href=\"document-relationship-type.html\">The type of relationship that this document has with anther document</a></span><span style=\"color: Gray\"> --&gt;</span>\r\n  &lt;<span title=\"Target of the relationship.\"><b>target</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>1..1</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/references.html#Resource\">Resource</a>(<a href=\"http://hl7.org/fhir/documentreference.html#DocumentReference\">DocumentReference</a>)</span> <span style=\"color: navy\">The target document of this relationship</span><span style=\"color: Gray\"> --&gt;</span>&lt;/target&gt;\r\n &lt;/relatesTo&gt;\r\n &lt;<span title=\"Represents the title of the document.\"><b>description</b></span> value=&quot;[<span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/datatypes.html#string\">string</a></span>]&quot;/&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>0..1</b></span> <span style=\"color: navy\">XDSDocumentEntry.title</span><span style=\"color: Gray\"> --&gt;</span>\r\n &lt;<span title=\"The code specifying the level of confidentiality of the XDS Document. These codes are specific to an XDS Affinity Domain.\"><b>confidentiality</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>1..1</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/datatypes.html#CodeableConcept\">CodeableConcept</a></span> <a style=\"color: navy\" href=\"v3/vs/Confidentiality/index.html\">XDSDocumentEntry.confidentialityCode</a><span style=\"color: Gray\"> --&gt;</span>&lt;/confidentiality&gt;\r\n &lt;<span title=\"Specifies the human language of character data in the document. The values of the attribute are language identifiers as described by the IETF (Internet Engineering Task Force) RFC 3066.\"><b>primaryLanguage</b></span> value=&quot;[<span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/datatypes.html#code\">code</a></span>]&quot;/&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>0..1</b></span> <span style=\"color: navy\"><a style=\"color: navy\" href=\"http://tools.ietf.org/html/bcp47.html\">XDSDocumentEntry.languageCode</a></span><span style=\"color: Gray\"> --&gt;</span>\r\n &lt;<span title=\"MIME type of the document in the Repository.\"><b>mimeType</b></span> value=&quot;[<span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/datatypes.html#code\">code</a></span>]&quot;/&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>1..1</b></span> <span style=\"color: navy\"><a style=\"color: navy\" href=\"http://www.rfc-editor.org/bcp/bcp13.txt.html\">XDSDocumentEntry.mimeType</a></span><span style=\"color: Gray\"> --&gt;</span>\r\n &lt;<span title=\"Code globally uniquely specifying the format of the document. Along with the typeCode, it should provide sufficient information to allow any potential XDS Document Consumer to know if it will be able to process the document. The formatCode shall be sufficiently specific to ensure processing/display by identifying a document encoding, structure and template (e.g., for a CDA Document, the fact that it complies with a CDA schema, possibly a template and the choice of a content-specific style sheet).\"><b>format</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>1..1</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/datatypes.html#CodeableConcept\">CodeableConcept</a></span> <span style=\"color: navy\">XDSDocumentEntry.formatCode</span><span style=\"color: Gray\"> --&gt;</span>&lt;/format&gt;\r\n &lt;<span title=\"Size in bytes of the byte stream that was provided in the Register and Provide Transaction and stored by the XDS Document Repository. This value is computed by the Document Repository and included in the Register Documents Set Transaction.\"><b>size</b></span> value=&quot;[<span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/datatypes.html#integer\">integer</a></span>]&quot;/&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>0..1</b></span> <span style=\"color: navy\">XDSDocumentEntry.size</span><span style=\"color: Gray\"> --&gt;</span>\r\n &lt;<span title=\"Hash key of the XDS Document itself.\"><b>hash</b></span> value=&quot;[<span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/datatypes.html#string\">string</a></span>]&quot;/&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>0..1</b></span> <span style=\"color: navy\">XDSDocumentEntry.hash</span><span style=\"color: Gray\"> --&gt;</span>\r\n &lt;<span title=\"Where to access the document.\"><b>location</b></span> value=&quot;[<span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/datatypes.html#uri\">uri</a></span>]&quot;/&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>0..1</b></span> <span style=\"color: navy\">repository location (by implication &amp; configuration)</span><span style=\"color: Gray\"> --&gt;</span>\r\n &lt;<span title=\"If access is not fully described by location.\"><b>service</b></span>&gt;  <span style=\"color: Gray\">&lt;!-- <span style=\"color: brown\"><b>0..0</b></span><span style=\"text-decoration: line-through\"> can be determined from repository location + parameters</span> --&gt;</span>\r\n &lt;/service&gt;\r\n &lt;<span title=\"Clinical context of document - eventCodeList, serviceStart &amp; Stop time, and facility type.\"><b>context</b></span>&gt;  <span style=\"color: Gray\">&lt;!-- <span style=\"color: brown\"><b>0..1</b></span> event codes, service Start &amp; Stop time, and facility type --&gt;</span>\r\n  <i class=\"inherited\">&lt;<span title=\"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 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.\"><b>extension</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>0..*</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/extensibility.html#Extension\">Extension</a></span> <span style=\"color: navy\">Additional Content defined by implementations</span><span style=\"color: Gray\"> --&gt;</span>&lt;/extension&gt;</i>\r\n  <i class=\"inherited\">&lt;<span title=\"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 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.\"><b>modifierExtension</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>0..*</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/extensibility.html#Extension\">Extension</a></span> <span style=\"color: navy\">Extensions that cannot be ignored</span><span style=\"color: Gray\"> --&gt;</span>&lt;/modifierExtension&gt;</i>\r\n  &lt;<span title=\"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 &quot;History and Physical Report&quot; in which the procedure being documented is necessarily a &quot;History and Physical&quot; act.\"><b>event</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>0..*</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/datatypes.html#CodeableConcept\">CodeableConcept</a></span> <a style=\"color: navy\" href=\"v3/ActCode/index.html\">XDSDocumentEntry.eventCodeList</a><span style=\"color: Gray\"> --&gt;</span>&lt;/event&gt;\r\n  &lt;<span title=\"The start and stop time of the service being documented took place.\"><b>period</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>1..1</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/datatypes.html#Period\">Period</a></span> <span style=\"color: navy\">\r\n      XDSDocumentEntry.serviceStartTime &amp; XDSDocumentEntry.serviceStopTime</span><span style=\"color: Gray\"> --&gt;</span>&lt;/period&gt;\r\n  &lt;<span title=\"This code represents the type of organizational setting of the clinical encounter during which the documented act occurred.\"><b>facilityType</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>0..1</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/datatypes.html#CodeableConcept\">CodeableConcept</a></span> <span style=\"color: navy\"><a style=\"color: navy\" href=\"valueset-xds-facilitycodes.html\">XDSDocumentEntry.healthCareFacilityTypeCode</a></span><span style=\"color: Gray\"> --&gt;</span>&lt;/facilityType&gt;\r\n &lt;/context&gt;\r\n&lt;/DocumentReference&gt;\r\n\r\n<span style=\"color: Gray\">&lt;!--<a name=\"DocumentManifest\"> </a><span style=\"color: Darkviolet\">DocumentManifest</span> --&gt;</span>\r\n&lt;<span title=\"A manifest that defines a set of documents.\"><b>DocumentManifest</b></span> xmlns=&quot;http://hl7.org/fhir&quot;&gt;\r\n &lt;!-- from Element: <a href=\"extensibility.html\">extension</a> --&gt;\r\n <i class=\"inherited\">&lt;<span title=\"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 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.\"><b>extension</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>0..*</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/extensibility.html#Extension\">Extension</a></span> <span style=\"color: navy\">Additional Content defined by implementations</span><span style=\"color: Gray\"> --&gt;</span>&lt;/extension&gt;</i>\r\n <i class=\"inherited\">&lt;<span title=\"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 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.\"><b>modifierExtension</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>0..*</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/extensibility.html#Extension\">Extension</a></span> <span style=\"color: navy\">Extensions that cannot be ignored</span><span style=\"color: Gray\"> --&gt;</span>&lt;/modifierExtension&gt;</i>\r\n <i class=\"inherited\">&lt;<span title=\"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 &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.\"><b>text</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>0..1</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/narrative.html#Narrative\">Narrative</a></span> <span style=\"color: navy\">Text summary of the resource, for human interpretation</span><span style=\"color: Gray\"> --&gt;</span>&lt;/text&gt;</i>\r\n <i class=\"inherited\">&lt;<span title=\"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.\"><b>contained</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>0..*</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/references.html#Resource\">Resource</a></span> <span style=\"color: navy\">Contained, inline Resources</span><span style=\"color: Gray\"> --&gt;</span>&lt;/contained&gt;</i>\r\n <i class=\"inherited\">&lt;<span title=\"A single identifier that uniquely identifies this manifest. Principally used to refer to the manifest in non-FHIR contexts.\"><b>masterIdentifier</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>1..1</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/datatypes.html#Identifier\">Identifier</a></span> <span style=\"color: navy\">Unique Identifier for the set of documents</span><span style=\"color: Gray\"> --&gt;</span>&lt;/masterIdentifier&gt;</i>\r\n &lt;<span title=\"A globally unique identifier for the SubmissionSet assigned by the creating entity.\"><b>identifier</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>1..1</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/datatypes.html#Identifier\">Identifier</a></span> <span style=\"color: navy\">SubmissionSet.uniqueId</span><span style=\"color: Gray\"> --&gt;</span>&lt;/identifier&gt;\r\n &lt;<span title=\"the subject of care whose longitudinal record is being reflected in this SubmissionSet.\"><b>subject</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>1..*</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/references.html#Resource\">Resource</a>(<a href=\"http://hl7.org/fhir/patient.html#Patient\">Patient</a>)</span> <span style=\"color: navy\">SubmissionSet.patientId</span><span style=\"color: Gray\"> --&gt;</span>&lt;/subject&gt;\r\n &lt;<span title=\"The organization(s) or person(s) for whom the SubmissionSet is intended.\"><b>recipient</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>0..*</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/references.html#Resource\">Resource</a>(<a href=\"http://hl7.org/fhir/patient.html#Patient\">Patient</a>|<a href=\"http://hl7.org/fhir/practitioner.html#Practitioner\">Practitioner</a>|<a href=\"http://hl7.org/fhir/organization.html#Organization\">Organization</a>)</span> <span style=\"color: navy\">\r\n     SubmissionSet.intendedRecipient&nbsp;</span><span style=\"color: Gray\"> --&gt;</span>&lt;/recipient&gt;\r\n &lt;<span title=\"The code specifying the type of clinical activity that resulted in placing the documents in this SubmissionSet.\"><b>type</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>0..1</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/datatypes.html#CodeableConcept\">CodeableConcept</a></span> <span style=\"color: navy\"><a style=\"color: navy\" href=\"valueset-docset-codes.html\">SubmissionSet.contentTypeCode</a></span><span style=\"color: Gray\"> --&gt;</span>&lt;/type&gt;\r\n &lt;<span title=\"The humans and/or machines that authored the document  in the SubmissionSet. This attribute contains the sub-attributes: authorInstitution, authorPerson, authorRole, authorSpecialty.\"><b>author</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>1..*</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/references.html#Resource\">Resource</a>(<a href=\"http://hl7.org/fhir/practitioner.html#Practitioner\">Practitioner</a>|<a href=\"http://hl7.org/fhir/device.html#Device\">Device</a>)</span> <span style=\"color: navy\">SubmissionSet.author</span><span style=\"color: Gray\"> --&gt;</span>&lt;/author&gt;\r\n &lt;<span title=\"Point in time at the creating entity when the SubmissionSet was created.\"><b>created</b></span> value=&quot;[<span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/datatypes.html#dateTime\">dateTime</a></span>]&quot;/&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>0..1</b></span> <span style=\"color: navy\">SubmissionSet.submissionTime</span><span style=\"color: Gray\"> --&gt;</span>\r\n &lt;<span title=\"OID identifying the instance of the creating entity that contributed the SubmissionSet.\"><b>source</b></span> value=&quot;[<span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/datatypes.html#uri\">uri</a></span>]&quot;/&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>0..1</b></span> <span style=\"color: navy\">SubmissionSet.sourceId</span><span style=\"color: Gray\"> --&gt;</span>\r\n &lt;<span title=\"The lifecycle status of the SubmissionSet.\"><b>status</b></span> value=&quot;[<span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/datatypes.html#code\">code</a></span>]&quot;/&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>1..1</b></span> <span style=\"color: navy\"><a style=\"color: navy\" href=\"document-reference-status.html\">SubmissionSet.availabilityStatus</a></span><span style=\"color: Gray\"> --&gt;</span>\r\n &lt;<span title=\"If this document manifest replaces another.\"><b>supercedes</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>0..1</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/references.html#Resource\">Resource</a>(<a href=\"http://hl7.org/fhir/documentmanifest.html#DocumentManifest\">DocumentManifest</a>)</span> <span style=\"color: navy\">todo</span><span style=\"color: Gray\"> --&gt;</span>&lt;/supercedes&gt;\r\n &lt;<span title=\"Human-readable description of the source document. This is sometimes known as the &quot;title&quot;.\"><b>description</b></span> value=&quot;[<span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/datatypes.html#string\">string</a></span>]&quot;/&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>0..1</b></span> <span style=\"color: navy\">SubmissionSet.title</span><span style=\"color: Gray\"> --&gt;</span>\r\n &lt;<span title=\"A code specifying the level of confidentiality of this set of Documents.\"><b>confidentiality</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>0..0</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/datatypes.html#CodeableConcept\">CodeableConcept</a></span> <span style=\"text-decoration: line-through\"><a style=\"color: navy\" href=\"v3/vs/Confidentiality/index.html\">SubmissionSet.confidentialityCode</a></span><span style=\"color: Gray\"> --&gt;</span>&lt;/confidentiality&gt;\r\n &lt;<span title=\"The list of resources that describe the parts of this document reference. Usually, these would be document references, but direct references to binary attachments and images are also allowed.\"><b>content</b></span>&gt;<span style=\"color: Gray\">&lt;!--</span> <span style=\"color: brown\"><b>1..*</b></span> <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/references.html#Resource\">Resource</a>(<a href=\"http://hl7.org/fhir/documentreference.html#DocumentReference\">DocumentReference</a>)</span> <span style=\"color: navy\">SubmissionSet.documentEntry</span><span style=\"color: Gray\"> --&gt;</span>&lt;/content&gt;\r\n&lt;/DocumentManifest&gt;\r\n\r\n<span style=\" color: Gray\">&lt;!-- <span style=\"color: Darkviolet\">Extensions</span> --&gt;</span>\r\n&lt;<span title=\"XDS allows multiple institutions for an author, but the Practitioner only allows one. If there a multiple institutions in an XDS record, use this extension for the additional ones.\"><b>extension</b></span>&gt;<a name=\"author-institution-repeats\"> </a>&lt;!--  <span style=\"color: brown\"><b>0..1</b></span> <span style=\"color: navy\">Context: Resource = Practitioner</span> --&gt;\r\n &lt;<b>url</b> value=&quot;<span style=\"color: maroon\">http://hl7.org/fhir/xds#author-institution-repeats</span>&quot;/&gt;\r\n &lt;<span title=\"XDS allows multiple institutions for an author, but the Practitioner only allows one. If there a multiple institutions in an XDS record, use this extension for the additional ones.\"><b>valueResourceReference</b></span>&gt;<span style=\" color: Gray\">&lt;!-- </span> <span style=\"color: brown;\"><b>0..1</b></span>  <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/references.html#Resource\">Resource</a>(<a href=\"http://hl7.org/fhir/organization.html#Organization\">Organization</a>)</span> <span style=\"color: navy\">Additional Institutions</span> <span style=\" color: Gray\">--&gt; </span>&lt;/valueResourceReference&gt;\r\n&lt;/extension&gt;\r\n\r\n&lt;<span title=\"The code specifying the clinical specialty where the act that resulted in the document was performed (e.g., Family Practice, Laboratory, Radiology).\"><b>extension</b></span>&gt;<a name=\"practiceSettingCode\"> </a>&lt;!--  <span style=\"color: brown\"><b>0..1</b></span> <span style=\"color: navy\">Context: Resource = DocumentReference</span> --&gt;\r\n &lt;<b>url</b> value=&quot;<span style=\"color: maroon\">http://hl7.org/fhir/xds#practiceSettingCode</span>&quot;/&gt;\r\n &lt;<span title=\"The code specifying the clinical specialty where the act that resulted in the document was performed (e.g., Family Practice, Laboratory, Radiology).\"><b>valueCodeableConcept</b></span>&gt;<span style=\" color: Gray\">&lt;!-- </span> <span style=\"color: brown;\"><b>0..1</b></span>  <span style=\"color: darkgreen\"><a href=\"http://hl7.org/fhir/datatypes.html#CodeableConcept\">CodeableConcept</a></span> <span style=\"color: navy\">XDSDocumentEntry.practiceSettingCode</span> <span style=\" color: Gray\">--&gt; </span>&lt;/valueCodeableConcept&gt;\r\n&lt;/extension&gt;\r\n\r\n</pre></div>"
  },
  "name": "XDS profile for Document Reference",
  "publisher": "HL7",
  "telecom": [
    {
      "system": "url",
      "value": "http://www.hl7.org"
    }
  ],
  "description": "Specific XDS profile for the general document reference functionality",
  "status": "draft",
  "date": "2012-06-24",
  "structure": [
    {
      "type": "DocumentReference",
      "name": "DocumentReference",
      "publish": true,
      "element": [
        {
          "path": "DocumentReference",
          "name": "DocumentReference",
          "definition": {
            "short": "XDSDocumentEntry",
            "formal": "A reference to a document.",
            "comments": "Usually, this is used for documents other than those defined by FHIR.",
            "min": 1,
            "max": "1",
            "type": [
              {
                "code": "Resource"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.extension",
          "name": "base extension",
          "slicing": {
            "discriminator": "url",
            "ordered": false,
            "rules": "open"
          }
        },
        {
          "path": "DocumentReference.extension",
          "definition": {
            "short": "Additional Content defined by implementations",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.extension.extension",
          "definition": {
            "short": "Additional Content defined by implementations",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "synonym": [
              "extensions",
              "user content"
            ],
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.extension.modifierExtension",
          "definition": {
            "short": "Extensions that cannot be ignored",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "synonym": [
              "extensions",
              "user content"
            ],
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.modifierExtension",
          "name": "base modifierExtension",
          "slicing": {
            "discriminator": "url",
            "ordered": false,
            "rules": "open"
          }
        },
        {
          "path": "DocumentReference.modifierExtension",
          "definition": {
            "short": "Extensions that cannot be ignored",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.modifierExtension.extension",
          "definition": {
            "short": "Additional Content defined by implementations",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "synonym": [
              "extensions",
              "user content"
            ],
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.modifierExtension.modifierExtension",
          "definition": {
            "short": "Extensions that cannot be ignored",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "synonym": [
              "extensions",
              "user content"
            ],
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.text",
          "definition": {
            "short": "Text summary of the resource, for human interpretation",
            "formal": "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.",
            "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative.",
            "synonym": [
              "narrative",
              "html",
              "xhtml",
              "display"
            ],
            "min": 0,
            "max": "1",
            "type": [
              {
                "code": "Narrative"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.contained",
          "definition": {
            "short": "Contained, inline Resources",
            "formal": "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.",
            "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.",
            "synonym": [
              "inline resources",
              "anonymous resources",
              "contained resources"
            ],
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Resource"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.text",
          "definition": {
            "short": "Text summary of the resource, for human interpretation",
            "formal": "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.",
            "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative.",
            "min": 0,
            "max": "1",
            "type": [
              {
                "code": "Narrative"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.contained",
          "definition": {
            "short": "Contained, inline Resources",
            "formal": "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.",
            "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.",
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Resource"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.masterIdentifier",
          "definition": {
            "short": "XDSDocumentEntry.uniqueId",
            "formal": "Globally unique identifier assigned to the document by the creating entity.\nA DocumentEntry representing a single document is identified by the uniqueId attribute; the linkage between DocumentEntry and the Document it represents is made with the uniqueId attribute.\nThis unique identifier may be used in other documents to reference this document.",
            "min": 1,
            "max": "1",
            "type": [
              {
                "code": "Identifier"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.identifier",
          "definition": {
            "short": "XDSDocumentEntry.referenceIdList",
            "formal": "Other identifiers for the document.",
            "comments": "Other identifiers can also include Identifiers may be Accession Numbers, Order Numbers, Referral Request  Identifiers, XDS Workflow Instance Identifiers.",
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Identifier"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.subject",
          "definition": {
            "short": "XDSDocumentEntry.patientId + sourcePatientId/sourcePatientInfo",
            "formal": "The patientId represents the subject of care of the document.  The value of the patientId shall be the same for all new documents of a SubmissionSet. Patient information typically includes: the patient first and last name, sex, and birth date.",
            "comments": "In the context of XDS, the patientId shall be the one with use = official. The Clinical XDS Affinity Domain policies may require more or less specific information and format. This patient information is not intended to be updated once the Document is registered (just as the Document content and metadata itself will not be updated without replacing the previous document). As sourcePatientInfo may have been updated by the source actor, it may no longer be in use within the Document Source (EHR-CR). It is only intended as an audit/checking mechanism and has occasional use for Document Consumer actors.",
            "min": 1,
            "max": "1",
            "type": [
              {
                "code": "ResourceReference",
                "profile": "http://hl7.org/fhir/profiles/Patient"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.type",
          "definition": {
            "short": "XDSDocumentEntry.typeCode",
            "formal": "The code specifying the particular kind of document (e.g., Prescription, Discharge Summary, Report). It is suggested that the XDS Affinity Domain draws these values from a coding scheme providing a coarse level of granularity (about 10 to 100 entries). Shall have a single value.",
            "comments": "Key metadata element describing the document, used in searching/filtering.",
            "min": 1,
            "max": "1",
            "type": [
              {
                "code": "CodeableConcept"
              }
            ],
            "isModifier": false,
            "binding": {
              "name": "DocumentType",
              "isExtensible": true,
              "conformance": "preferred",
              "referenceResource": {
                "reference": "http://hl7.org/fhir/vs/doc-codes"
              }
            }
          }
        },
        {
          "path": "DocumentReference.class",
          "definition": {
            "short": "XDSDocumentEntry.classCode",
            "formal": "A categorization for the type of the document. This may be implied by or derived from the code specified in the Document Type.",
            "comments": "XDSDocumentEntry.typeCode.",
            "min": 1,
            "max": "1",
            "type": [
              {
                "code": "CodeableConcept"
              }
            ],
            "isModifier": false,
            "binding": {
              "name": "DocumentClass",
              "isExtensible": true,
              "conformance": "example",
              "referenceResource": {
                "reference": "http://hl7.org/fhir/vs/xds-typecodes"
              }
            }
          }
        },
        {
          "path": "DocumentReference.author",
          "definition": {
            "short": "XDSDocumentEntry.author",
            "formal": "Represents the humans and/or machines that authored the document.",
            "comments": "Not necessarily who did the actual data entry (i.e. typist) it in or who was the source (informant).",
            "min": 1,
            "max": "*",
            "type": [
              {
                "code": "ResourceReference",
                "profile": "http://hl7.org/fhir/profiles/Practitioner"
              },
              {
                "code": "ResourceReference",
                "profile": "http://hl7.org/fhir/profiles/Device"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.custodian",
          "definition": {
            "short": "n/a",
            "formal": "Org which maintains the document.",
            "comments": "Identifies the logical organization to go to find the current version, where to report issues, etc. This is different from the physical location of the document, which is the technical location of the document, which host may be delegated to the management of some other organization.",
            "min": 0,
            "max": "0",
            "type": [
              {
                "code": "ResourceReference",
                "profile": "http://hl7.org/fhir/profiles/Organization"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.policyManager",
          "definition": {
            "short": "XDSDocumentEntry.homeCommunityId",
            "formal": "A globally unique identifier for a community with which this document is associated.",
            "min": 0,
            "max": "1",
            "type": [
              {
                "code": "uri"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.authenticator",
          "definition": {
            "short": "??",
            "formal": "Represents a participant who has legally authenticated or attested the document within the authorInstitution. Legal authentication implies that a document has been signed manually or electronically by the legalAuthenticator.",
            "min": 0,
            "max": "1",
            "type": [
              {
                "code": "ResourceReference",
                "profile": "http://hl7.org/fhir/profiles/Practitioner"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.created",
          "definition": {
            "short": "XDSDocumentEntry.creationTime",
            "formal": "Represents the time the author created the document in the Document Source.",
            "comments": "Creation time is used for tracking, organizing versions and searching. This is the creation time of the document, not the source material on which it is based.",
            "min": 1,
            "max": "1",
            "type": [
              {
                "code": "dateTime"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.indexed",
          "definition": {
            "short": "XDS submission time or XDSDocumentEntry.creationTime  if unknown",
            "formal": "When this document reference created.",
            "comments": "Referencing/indexing time is used for tracking, organizing versions and searching.",
            "min": 1,
            "max": "1",
            "type": [
              {
                "code": "instant"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.status",
          "definition": {
            "short": "implied by XDS workflow",
            "formal": "This attribute is always set to Approved as part of the submission of new XDS Documents. It may be changed to Deprecated under the primary responsibility of the Document Source with possible patient supervision. Although XDS supports the ability to delete documents, there is no such state as “the Document Entry is removed” (only an audit trail is kept if such a deletion is allowed).",
            "min": 1,
            "max": "1",
            "type": [
              {
                "code": "code"
              }
            ],
            "isModifier": false,
            "binding": {
              "name": "DocumentReferenceStatus",
              "isExtensible": false,
              "conformance": "required",
              "referenceResource": {
                "reference": "http://hl7.org/fhir/vs/document-reference-status"
              }
            }
          }
        },
        {
          "path": "DocumentReference.docStatus",
          "definition": {
            "short": "preliminary | final | appended | amended | entered in error",
            "formal": "Status of the underlying document.",
            "min": 0,
            "max": "0",
            "type": [
              {
                "code": "CodeableConcept"
              }
            ],
            "isModifier": false,
            "binding": {
              "name": "ReferredDocumentStatus",
              "isExtensible": true,
              "conformance": "preferred",
              "referenceResource": {
                "reference": "http://hl7.org/fhir/vs/composition-status"
              }
            }
          }
        },
        {
          "path": "DocumentReference.relatesTo",
          "definition": {
            "short": "Relationships that this document has with other document references that already exist",
            "formal": "Relationships to other documents.",
            "min": 0,
            "max": "*",
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.relatesTo.extension",
          "name": "base extension",
          "slicing": {
            "discriminator": "url",
            "ordered": false,
            "rules": "open"
          }
        },
        {
          "path": "DocumentReference.relatesTo.extension",
          "definition": {
            "short": "Additional Content defined by implementations",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.relatesTo.extension.extension",
          "definition": {
            "short": "Additional Content defined by implementations",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "synonym": [
              "extensions",
              "user content"
            ],
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.relatesTo.extension.modifierExtension",
          "definition": {
            "short": "Extensions that cannot be ignored",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "synonym": [
              "extensions",
              "user content"
            ],
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.relatesTo.modifierExtension",
          "name": "base modifierExtension",
          "slicing": {
            "discriminator": "url",
            "ordered": false,
            "rules": "open"
          }
        },
        {
          "path": "DocumentReference.relatesTo.modifierExtension",
          "definition": {
            "short": "Extensions that cannot be ignored",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.relatesTo.modifierExtension.extension",
          "definition": {
            "short": "Additional Content defined by implementations",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "synonym": [
              "extensions",
              "user content"
            ],
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.relatesTo.modifierExtension.modifierExtension",
          "definition": {
            "short": "Extensions that cannot be ignored",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "synonym": [
              "extensions",
              "user content"
            ],
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.relatesTo.code",
          "definition": {
            "short": "The type of relationship that this document has with anther document",
            "formal": "supercedes | transforms | signs | appends.",
            "comments": "If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.",
            "min": 1,
            "max": "1",
            "type": [
              {
                "code": "code"
              }
            ],
            "isModifier": false,
            "binding": {
              "name": "DocumentRelationshipType",
              "isExtensible": false,
              "conformance": "required",
              "referenceResource": {
                "reference": "http://hl7.org/fhir/vs/document-relationship-type"
              }
            }
          }
        },
        {
          "path": "DocumentReference.relatesTo.target",
          "definition": {
            "short": "The target document of this relationship",
            "formal": "Target of the relationship.",
            "min": 1,
            "max": "1",
            "type": [
              {
                "code": "ResourceReference",
                "profile": "http://hl7.org/fhir/profiles/DocumentReference"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.description",
          "definition": {
            "short": "XDSDocumentEntry.title",
            "formal": "Represents the title of the document.",
            "comments": "What the document is about, rather than a terse summary of the document. It is commonly the case that records do not have a title and are collectively referred to by the display name of Record code (e.g. a \"consultation\" or \"progress note\").",
            "min": 0,
            "max": "1",
            "type": [
              {
                "code": "string"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.confidentiality",
          "definition": {
            "short": "XDSDocumentEntry.confidentialityCode",
            "formal": "The code specifying the level of confidentiality of the XDS Document. These codes are specific to an XDS Affinity Domain.",
            "comments": "Enforcement and issues related to highly sensitive documents are beyond the scope of XDS (see security section). confidentialityCode is part of a codification scheme and value set enforced by the Document Registry.",
            "min": 1,
            "max": "1",
            "type": [
              {
                "code": "CodeableConcept"
              }
            ],
            "isModifier": false,
            "binding": {
              "name": "DocumentConfidentiality",
              "isExtensible": true,
              "conformance": "preferred",
              "referenceResource": {
                "reference": "http://hl7.org/fhir/v3/vs/Confidentiality"
              }
            }
          }
        },
        {
          "path": "DocumentReference.primaryLanguage",
          "definition": {
            "short": "XDSDocumentEntry.languageCode",
            "formal": "Specifies the human language of character data in the document. The values of the attribute are language identifiers as described by the IETF (Internet Engineering Task Force) RFC 3066.",
            "comments": "This value may further be restricted by the registry according to XDS Affinity Domain specific policy.",
            "min": 0,
            "max": "1",
            "type": [
              {
                "code": "code"
              }
            ],
            "isModifier": false,
            "binding": {
              "name": "Language",
              "isExtensible": false,
              "conformance": "required",
              "referenceUri": "http://tools.ietf.org/html/bcp47"
            }
          }
        },
        {
          "path": "DocumentReference.mimeType",
          "definition": {
            "short": "XDSDocumentEntry.mimeType",
            "formal": "MIME type of the document in the Repository.",
            "comments": "Note: application/hl7-v3+xml for CDA. application/binary for proprietary record formats.",
            "min": 1,
            "max": "1",
            "type": [
              {
                "code": "code"
              }
            ],
            "isModifier": false,
            "binding": {
              "name": "MimeType",
              "isExtensible": false,
              "conformance": "required",
              "referenceUri": "http://www.rfc-editor.org/bcp/bcp13.txt"
            }
          }
        },
        {
          "path": "DocumentReference.format",
          "definition": {
            "short": "XDSDocumentEntry.formatCode",
            "formal": "Code globally uniquely specifying the format of the document. Along with the typeCode, it should provide sufficient information to allow any potential XDS Document Consumer to know if it will be able to process the document. The formatCode shall be sufficiently specific to ensure processing/display by identifying a document encoding, structure and template (e.g., for a CDA Document, the fact that it complies with a CDA schema, possibly a template and the choice of a content-specific style sheet).",
            "comments": "Format codes may be specified by multiple organizations. Format codes defined by ITI shall have names with the prefix urn:ihe:iti:. Format codes defined by other IHE domains shall have names with the prefix urn:ihe:’domain initials’: Format codes defined by the Affinity Domain shall have names with the prefix urn:ad:’name of affinity domain’: Affinity Domains shall be unique. The prefixes described here are not assumed to be exhaustive.",
            "min": 1,
            "max": "1",
            "type": [
              {
                "code": "CodeableConcept"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.size",
          "definition": {
            "short": "XDSDocumentEntry.size",
            "formal": "Size in bytes of the byte stream that was provided in the Register and Provide Transaction and stored by the XDS Document Repository. This value is computed by the Document Repository and included in the Register Documents Set Transaction.",
            "min": 0,
            "max": "1",
            "type": [
              {
                "code": "integer"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.hash",
          "definition": {
            "short": "XDSDocumentEntry.hash",
            "formal": "Hash key of the XDS Document itself.",
            "comments": "This value is computed by the Document Repository and used by the Document Registry for detecting the improper resubmission of XDS Documents. If present, shall have a single value. If this attribute is received in a Provide & Register Document Set-b [ITI-41] transaction, it shall be verified by the repository with the actual hash value of the submitted document; an XDSRepositoryMetadataError shall be returned on mismatch.",
            "min": 0,
            "max": "1",
            "type": [
              {
                "code": "string"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.location",
          "definition": {
            "short": "repository location (by implication & configuration)",
            "formal": "Where to access the document.",
            "min": 0,
            "max": "1",
            "type": [
              {
                "code": "uri"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.service",
          "definition": {
            "short": "can be determined from repository location + parameters",
            "formal": "If access is not fully described by location.",
            "comments": "If a document can be accessed by either a service or directly by a URL (i.e. an XDS repository with an MHD access point, or a DICOM network with a WADO portal) just provide the URL.",
            "min": 0,
            "max": "0",
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.service.extension",
          "name": "base extension",
          "slicing": {
            "discriminator": "url",
            "ordered": false,
            "rules": "open"
          }
        },
        {
          "path": "DocumentReference.service.extension",
          "definition": {
            "short": "Additional Content defined by implementations",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.service.extension.extension",
          "definition": {
            "short": "Additional Content defined by implementations",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "synonym": [
              "extensions",
              "user content"
            ],
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.service.extension.modifierExtension",
          "definition": {
            "short": "Extensions that cannot be ignored",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "synonym": [
              "extensions",
              "user content"
            ],
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.service.modifierExtension",
          "name": "base modifierExtension",
          "slicing": {
            "discriminator": "url",
            "ordered": false,
            "rules": "open"
          }
        },
        {
          "path": "DocumentReference.service.modifierExtension",
          "definition": {
            "short": "Extensions that cannot be ignored",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.service.modifierExtension.extension",
          "definition": {
            "short": "Additional Content defined by implementations",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "synonym": [
              "extensions",
              "user content"
            ],
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.service.modifierExtension.modifierExtension",
          "definition": {
            "short": "Extensions that cannot be ignored",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "synonym": [
              "extensions",
              "user content"
            ],
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.service.type",
          "definition": {
            "short": "Type of service (i.e. XDS.b)",
            "formal": "The type of the service that can be used to access the documents.",
            "comments": "The meaning and interpretation of the parameters depends on the service type.",
            "min": 1,
            "max": "1",
            "type": [
              {
                "code": "CodeableConcept"
              }
            ],
            "isModifier": false,
            "binding": {
              "name": "DocumentServiceType",
              "isExtensible": true,
              "conformance": "preferred",
              "referenceResource": {
                "reference": "http://hl7.org/fhir/vs/documentreference-service-types"
              }
            }
          }
        },
        {
          "path": "DocumentReference.service.address",
          "definition": {
            "short": "Where service is located (usually a URL)",
            "formal": "Where the service end-point is located.",
            "comments": "Usually this is a URL, but for some services, the end-point is a simple network name or address that is not a valid URL.",
            "min": 0,
            "max": "1",
            "type": [
              {
                "code": "string"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.service.parameter",
          "definition": {
            "short": "Service call parameters",
            "formal": "A list of named parameters that is used in the service call.",
            "comments": "The interpretation of the parameters, and how to convert them into a proper service call, is dependent on the type of the service, and needs to be specified in an implementation guide somewhere.",
            "min": 0,
            "max": "*",
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.service.parameter.extension",
          "name": "base extension",
          "slicing": {
            "discriminator": "url",
            "ordered": false,
            "rules": "open"
          }
        },
        {
          "path": "DocumentReference.service.parameter.extension",
          "definition": {
            "short": "Additional Content defined by implementations",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.service.parameter.extension.extension",
          "definition": {
            "short": "Additional Content defined by implementations",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "synonym": [
              "extensions",
              "user content"
            ],
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.service.parameter.extension.modifierExtension",
          "definition": {
            "short": "Extensions that cannot be ignored",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "synonym": [
              "extensions",
              "user content"
            ],
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.service.parameter.modifierExtension",
          "name": "base modifierExtension",
          "slicing": {
            "discriminator": "url",
            "ordered": false,
            "rules": "open"
          }
        },
        {
          "path": "DocumentReference.service.parameter.modifierExtension",
          "definition": {
            "short": "Extensions that cannot be ignored",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.service.parameter.modifierExtension.extension",
          "definition": {
            "short": "Additional Content defined by implementations",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "synonym": [
              "extensions",
              "user content"
            ],
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.service.parameter.modifierExtension.modifierExtension",
          "definition": {
            "short": "Extensions that cannot be ignored",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "synonym": [
              "extensions",
              "user content"
            ],
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.service.parameter.name",
          "definition": {
            "short": "Parameter name in service call",
            "formal": "The name of a parameter.",
            "min": 1,
            "max": "1",
            "type": [
              {
                "code": "string"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.service.parameter.value",
          "definition": {
            "short": "Parameter value for the name",
            "formal": "The value of the named parameter.",
            "min": 0,
            "max": "1",
            "type": [
              {
                "code": "string"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.context",
          "definition": {
            "short": "event codes, service Start & Stop time, and facility type",
            "formal": "Clinical context of document - eventCodeList, serviceStart & Stop time, and facility type.",
            "comments": "These values are primarily added to help with searching for interesting/relevant documents.",
            "min": 0,
            "max": "1",
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.context.extension",
          "name": "base extension",
          "slicing": {
            "discriminator": "url",
            "ordered": false,
            "rules": "open"
          }
        },
        {
          "path": "DocumentReference.context.extension",
          "definition": {
            "short": "Additional Content defined by implementations",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.context.extension.extension",
          "definition": {
            "short": "Additional Content defined by implementations",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "synonym": [
              "extensions",
              "user content"
            ],
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.context.extension.modifierExtension",
          "definition": {
            "short": "Extensions that cannot be ignored",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "synonym": [
              "extensions",
              "user content"
            ],
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.context.modifierExtension",
          "name": "base modifierExtension",
          "slicing": {
            "discriminator": "url",
            "ordered": false,
            "rules": "open"
          }
        },
        {
          "path": "DocumentReference.context.modifierExtension",
          "definition": {
            "short": "Extensions that cannot be ignored",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.context.modifierExtension.extension",
          "definition": {
            "short": "Additional Content defined by implementations",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "synonym": [
              "extensions",
              "user content"
            ],
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.context.modifierExtension.modifierExtension",
          "definition": {
            "short": "Extensions that cannot be ignored",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "synonym": [
              "extensions",
              "user content"
            ],
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.context.event",
          "definition": {
            "short": "XDSDocumentEntry.eventCodeList",
            "formal": "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.",
            "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.",
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "CodeableConcept"
              }
            ],
            "isModifier": false,
            "binding": {
              "name": "DocumentEventType",
              "isExtensible": true,
              "conformance": "preferred",
              "referenceResource": {
                "reference": "http://hl7.org/fhir/v3/vs/ActCode"
              }
            }
          }
        },
        {
          "path": "DocumentReference.context.period",
          "definition": {
            "short": "XDSDocumentEntry.serviceStartTime & XDSDocumentEntry.serviceStopTime",
            "formal": "The start and stop time of the service being documented took place.",
            "comments": "At least a start date SHALL be provided.",
            "min": 1,
            "max": "1",
            "type": [
              {
                "code": "Period"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentReference.context.facilityType",
          "definition": {
            "short": "XDSDocumentEntry.healthCareFacilityTypeCode",
            "formal": "This code represents the type of organizational setting of the clinical encounter during which the documented act occurred.",
            "comments": "In some cases, the setting of the encounter is inherent in the typeCode, such as \"Diabetes Clinic Progress Note\". healthcareFacilityTypeCode shall be equivalent to or further specialize the value inherent in the typeCode; for example, where the typeCode is simply \"Clinic Progress Note\" and the value of healthcareFacilityTypeCode is \"private clinic\". The value shall not conflict with the value inherent in the typeCode, as such a conflict would create an ambiguous situation.",
            "min": 0,
            "max": "1",
            "type": [
              {
                "code": "CodeableConcept"
              }
            ],
            "isModifier": false,
            "binding": {
              "name": "DocumentFacilityType",
              "isExtensible": true,
              "conformance": "example",
              "referenceResource": {
                "reference": "http://hl7.org/fhir/vs/xds-facilitycodes"
              }
            }
          }
        }
      ]
    },
    {
      "type": "DocumentManifest",
      "name": "DocumentManifest",
      "publish": true,
      "element": [
        {
          "path": "DocumentManifest",
          "name": "DocumentManifest",
          "definition": {
            "short": "SubmissionSet",
            "formal": "A manifest that defines a set of documents.",
            "min": 1,
            "max": "1",
            "type": [
              {
                "code": "Resource"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentManifest.extension",
          "name": "base extension",
          "slicing": {
            "discriminator": "url",
            "ordered": false,
            "rules": "open"
          }
        },
        {
          "path": "DocumentManifest.extension",
          "definition": {
            "short": "Additional Content defined by implementations",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentManifest.extension.extension",
          "definition": {
            "short": "Additional Content defined by implementations",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "synonym": [
              "extensions",
              "user content"
            ],
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentManifest.extension.modifierExtension",
          "definition": {
            "short": "Extensions that cannot be ignored",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "synonym": [
              "extensions",
              "user content"
            ],
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentManifest.modifierExtension",
          "name": "base modifierExtension",
          "slicing": {
            "discriminator": "url",
            "ordered": false,
            "rules": "open"
          }
        },
        {
          "path": "DocumentManifest.modifierExtension",
          "definition": {
            "short": "Extensions that cannot be ignored",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentManifest.modifierExtension.extension",
          "definition": {
            "short": "Additional Content defined by implementations",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "synonym": [
              "extensions",
              "user content"
            ],
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentManifest.modifierExtension.modifierExtension",
          "definition": {
            "short": "Extensions that cannot be ignored",
            "formal": "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 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.",
            "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 simplicity for everyone.",
            "synonym": [
              "extensions",
              "user content"
            ],
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Extension"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentManifest.text",
          "definition": {
            "short": "Text summary of the resource, for human interpretation",
            "formal": "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.",
            "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative.",
            "synonym": [
              "narrative",
              "html",
              "xhtml",
              "display"
            ],
            "min": 0,
            "max": "1",
            "type": [
              {
                "code": "Narrative"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentManifest.contained",
          "definition": {
            "short": "Contained, inline Resources",
            "formal": "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.",
            "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.",
            "synonym": [
              "inline resources",
              "anonymous resources",
              "contained resources"
            ],
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Resource"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentManifest.text",
          "definition": {
            "short": "Text summary of the resource, for human interpretation",
            "formal": "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.",
            "comments": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative.",
            "min": 0,
            "max": "1",
            "type": [
              {
                "code": "Narrative"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentManifest.contained",
          "definition": {
            "short": "Contained, inline Resources",
            "formal": "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.",
            "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.",
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "Resource"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentManifest.masterIdentifier",
          "definition": {
            "short": "Unique Identifier for the set of documents",
            "formal": "A single identifier that uniquely identifies this manifest. Principally used to refer to the manifest in non-FHIR contexts.",
            "min": 1,
            "max": "1",
            "type": [
              {
                "code": "Identifier"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentManifest.identifier",
          "definition": {
            "short": "SubmissionSet.uniqueId",
            "formal": "A globally unique identifier for the SubmissionSet assigned by the creating entity.",
            "comments": "Other identifiers can also include Identifiers may be Accession Numbers, Order Numbers, Referral Request  Identifiers, XDS Workflow Instance Identifiers.",
            "min": 1,
            "max": "1",
            "type": [
              {
                "code": "Identifier"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentManifest.subject",
          "definition": {
            "short": "SubmissionSet.patientId",
            "formal": "the subject of care whose longitudinal record is being reflected in this SubmissionSet.",
            "min": 1,
            "max": "*",
            "type": [
              {
                "code": "ResourceReference",
                "profile": "http://hl7.org/fhir/profiles/Patient"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentManifest.recipient",
          "definition": {
            "short": "SubmissionSet.intendedRecipient ",
            "formal": "The organization(s) or person(s) for whom the SubmissionSet is intended.",
            "comments": "How the recipient receives the document set or is notified of it is up to the implementation. This element is just a statement of intent.",
            "min": 0,
            "max": "*",
            "type": [
              {
                "code": "ResourceReference",
                "profile": "http://hl7.org/fhir/profiles/Patient"
              },
              {
                "code": "ResourceReference",
                "profile": "http://hl7.org/fhir/profiles/Practitioner"
              },
              {
                "code": "ResourceReference",
                "profile": "http://hl7.org/fhir/profiles/Organization"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentManifest.type",
          "definition": {
            "short": "SubmissionSet.contentTypeCode",
            "formal": "The code specifying the type of clinical activity that resulted in placing the documents in this SubmissionSet.",
            "min": 0,
            "max": "1",
            "type": [
              {
                "code": "CodeableConcept"
              }
            ],
            "isModifier": false,
            "binding": {
              "name": "DocumentSetType",
              "isExtensible": true,
              "conformance": "preferred",
              "referenceResource": {
                "reference": "http://hl7.org/fhir/vs/docset-codes"
              }
            }
          }
        },
        {
          "path": "DocumentManifest.author",
          "definition": {
            "short": "SubmissionSet.author",
            "formal": "The humans and/or machines that authored the document  in the SubmissionSet. This attribute contains the sub-attributes: authorInstitution, authorPerson, authorRole, authorSpecialty.",
            "comments": "Not necessarily who did the actual data entry (i.e. typist) or who was the source (informant).",
            "min": 1,
            "max": "*",
            "type": [
              {
                "code": "ResourceReference",
                "profile": "http://hl7.org/fhir/profiles/Practitioner"
              },
              {
                "code": "ResourceReference",
                "profile": "http://hl7.org/fhir/profiles/Device"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentManifest.created",
          "definition": {
            "short": "SubmissionSet.submissionTime",
            "formal": "Point in time at the creating entity when the SubmissionSet was created.",
            "comments": "Creation time is used for tracking, organizing versions and searching. This is the creation time of the document set, not the documents on which it is based.",
            "min": 0,
            "max": "1",
            "type": [
              {
                "code": "dateTime"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentManifest.source",
          "definition": {
            "short": "SubmissionSet.sourceId",
            "formal": "OID identifying the instance of the creating entity that contributed the SubmissionSet.",
            "min": 0,
            "max": "1",
            "type": [
              {
                "code": "uri"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentManifest.status",
          "definition": {
            "short": "SubmissionSet.availabilityStatus",
            "formal": "The lifecycle status of the SubmissionSet.",
            "min": 1,
            "max": "1",
            "type": [
              {
                "code": "code"
              }
            ],
            "isModifier": false,
            "binding": {
              "name": "DocumentReferenceStatus",
              "isExtensible": false,
              "conformance": "required",
              "referenceResource": {
                "reference": "http://hl7.org/fhir/vs/document-reference-status"
              }
            }
          }
        },
        {
          "path": "DocumentManifest.supercedes",
          "definition": {
            "short": "todo",
            "formal": "If this document manifest replaces another.",
            "min": 0,
            "max": "1",
            "type": [
              {
                "code": "ResourceReference",
                "profile": "http://hl7.org/fhir/profiles/DocumentManifest"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentManifest.description",
          "definition": {
            "short": "SubmissionSet.title",
            "formal": "Human-readable description of the source document. This is sometimes known as the \"title\".",
            "comments": "What the document is about, rather than a terse summary of the document. It is commonly the case that records do not have a title and are collectively referred to by the display name of Record code (e.g. a \"consultation\" or \"progress note\").",
            "min": 0,
            "max": "1",
            "type": [
              {
                "code": "string"
              }
            ],
            "isModifier": false
          }
        },
        {
          "path": "DocumentManifest.confidentiality",
          "definition": {
            "short": "SubmissionSet.confidentialityCode",
            "formal": "A code specifying the level of confidentiality of this set of Documents.",
            "comments": "The document set is at least as confidential as the most confidential of the documents in it.",
            "min": 0,
            "max": "0",
            "type": [
              {
                "code": "CodeableConcept"
              }
            ],
            "isModifier": false,
            "binding": {
              "name": "DocumentConfidentiality",
              "isExtensible": true,
              "conformance": "preferred",
              "referenceResource": {
                "reference": "http://hl7.org/fhir/v3/vs/Confidentiality"
              }
            }
          }
        },
        {
          "path": "DocumentManifest.content",
          "definition": {
            "short": "SubmissionSet.documentEntry",
            "formal": "The list of resources that describe the parts of this document reference. Usually, these would be document references, but direct references to binary attachments and images are also allowed.",
            "min": 1,
            "max": "*",
            "type": [
              {
                "code": "ResourceReference",
                "profile": "http://hl7.org/fhir/profiles/DocumentReference"
              }
            ],
            "isModifier": false
          }
        }
      ]
    }
  ],
  "extensionDefn": [
    {
      "code": "author-institution-repeats",
      "display": "Additional Institutions",
      "contextType": "resource",
      "context": [
        "Practitioner"
      ],
      "definition": {
        "short": "Additional Institutions",
        "formal": "XDS allows multiple institutions for an author, but the Practitioner only allows one. If there a multiple institutions in an XDS record, use this extension for the additional ones.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Resource(Organization)"
          }
        ],
        "mustSupport": false,
        "isModifier": false
      }
    },
    {
      "code": "practiceSettingCode",
      "display": "XDSDocumentEntry.practiceSettingCode",
      "contextType": "resource",
      "context": [
        "DocumentReference"
      ],
      "definition": {
        "short": "XDSDocumentEntry.practiceSettingCode",
        "formal": "The code specifying the clinical specialty where the act that resulted in the document was performed (e.g., Family Practice, Laboratory, Radiology).",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false
      }
    }
  ]
}