SMART App Launch
2.2.0 - STU 2.2 International flag

This page is part of the Smart App Launch Implementation Guide (v2.2.0: STU 2.2) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Resource Profile: UserAccessBrand - Detailed Descriptions

Active as of 2023-03-05

Definitions for the user-access-brand resource profile.

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

0. Organization
Definition

A brand of a healthcare provider, such as a hospital, clinic, or practice

ShortUser Access Brand
Invariantsuab-1: Portal endpoints must also appear at Organization.endpoint (Organization.extension('http://hl7.org/fhir/StructureDefinition/organization-portal').extension('portalEndpoint').value.ofType(Reference).reference.subsetOf(%resource.endpoint.reference))
2. Organization.extension
SlicingThis element introduces a set of slices on Organization.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 4. Organization.extension:brand
    Slice Namebrand
    ShortBrand Details
    Control0..*
    TypeExtension(Organization Brand) (Complex Extension)
    Must Supporttrue
    6. Organization.extension:portal
    Slice Nameportal
    ShortPortal Details
    Control0..*
    TypeExtension(Organization Portal) (Complex Extension)
    Must Supporttrue
    8. Organization.identifier
    Definition

    The unique identifier for the brand that apps can use to link this Brand across publishers or with external data sets. EHRs SHALL support customer-supplied identifiers (system and value).

    • It is RECOMMENDED that each Brand include an identifier where system is urn:ietf:rfc: 3986 (meaning the identifier is a URL) and value is the HTTPS URL for the Brand's primary web presence, omitting any "www." prefix from the domain and omitting any path component. For example, since the main web presence of Boston Children's Hospital is https: //www.childrenshospital.org/, a recommended identifier would be:

      { "system": "urn:ietf:rfc:3986", "value": "https://childrenshospital.org" }

    ShortUnique identifier for the brand
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Must Supporttrue
    10. Organization.type
    Must Supporttrue
    SlicingThis element introduces a set of slices on Organization.type. The slices are unordered and Open, and can be differentiated using the following discriminators:
    • value @ $this
    • 12. Organization.type:pab
      Slice Namepab
      ShortCategories of user access offered
      Control0..?
      BindingThe codes SHALL be taken from User Access Category Value Set
      (required to http://hl7.org/fhir/smart-app-launch/ValueSet/user-access-category)
      Must Supporttrue
      14. Organization.name
      Definition

      The primary brand name to display on a card.

      ShortPrimary brand name to display on a card
      Control1..?
      Must Supporttrue
      16. Organization.alias
      Definition

      Aliases (e.g., former names like "Partners Healthcare") for filtering/search

      ShortAliases (e.g., former names like "Partners Healthcare") for filtering/search
      Must Supporttrue
      18. Organization.telecom
      Definition

      telecom with system of url and value conveying the primary public website for the Brand. Note this is distinct from the user access portal website.

      ShortThe primary public website for the Brand.
      Control1..1
      Must Supporttrue
      20. Organization.address
      Definition

      Locations (e.g., zip codes and/or street addresses) associated with the Brand. The following combinations are allowed, and as a best practice to ensure consistent worldwide adoption, the Address.country data element SHOULD be populated inside any of these with an ISO 3166-1 alpha-2 country code:

      • State
      • City, state
      • City, state, zip code
      • Street address, city, state, zip code
      • zip code alone
      ShortLocations (e.g., zip codes and/or street addresses) associated with the Brand.
      Must Supporttrue
      22. Organization.partOf
      Definition

      Affiliated "parent brand", if this Brand is part of a larger health system. "User access provided by", to convey that an affiliated Brand hosts this Brand's API technology and user portal. The hierarchy of "access provided by" links SHALL NOT exceed a depth of two (i.e., a Brand either includes portal details or links directly to a Brand that provides them).

      ShortAffiliated "parent brand", if this Brand is part of a larger health system
      Must Supporttrue
      24. Organization.endpoint
      Definition

      References one or more UserAccessEndpoints. Endpoints here will also be listed within the organization-portal extension, to indicate the specific portal they're associated with.

      ShortEndpoint associated with this brand
      TypeReference(User Access Endpoint Profile)bundled
      Must Supporttrue
      26. Organization.endpoint.reference
      Definition

      Relative URL to an Endpoint within the User Access Brands Bundle

      ShortRelative URL to an Endpoint within the User Access Brands Bundle
      Must Supporttrue

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

      0. Organization
      Definition

      A brand of a healthcare provider, such as a hospital, clinic, or practice


      A formally or informally recognized grouping of people or organizations formed for the purpose of achieving some form of collective action. Includes companies, institutions, corporations, departments, community groups, healthcare practice groups, payer/insurer, etc.

      ShortUser Access BrandA grouping of people or organizations with a common purpose
      Control0..*
      Is Modifierfalse
      Summaryfalse
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
      dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
      dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      org-1: The organization SHALL at least have a name or an identifier, and possibly more than one ((identifier.count() + name.count()) > 0)
      uab-1: Portal endpoints must also appear at Organization.endpoint (Organization.extension('http://hl7.org/fhir/StructureDefinition/organization-portal').extension('portalEndpoint').value.ofType(Reference).reference.subsetOf(%resource.endpoint.reference))
      org-1: The organization SHALL at least have a name or an identifier, and possibly more than one ((identifier.count() + name.count()) > 0)
      2. Organization.implicitRules
      Definition

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

      ShortA set of rules under which this content was created
      Comments

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

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

      An Extension


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

      ShortExtensionAdditional content defined by implementations
      Comments

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

      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on Organization.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 6. Organization.extension:brand
        Slice Namebrand
        Definition

        Organization-level Brand information.

        ShortBrand Details
        Control0..*
        TypeExtension(Organization Brand) (Complex Extension)
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        8. Organization.extension:portal
        Slice Nameportal
        Definition

        Organization-level portal information.

        ShortPortal Details
        Control0..*
        TypeExtension(Organization Portal) (Complex Extension)
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        10. Organization.modifierExtension
        Definition

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

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

        ShortExtensions that cannot be ignored
        Comments

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

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

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

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

        The unique identifier for the brand that apps can use to link this Brand across publishers or with external data sets. EHRs SHALL support customer-supplied identifiers (system and value).

        • It is RECOMMENDED that each Brand include an identifier where system is urn:ietf:rfc: 3986 (meaning the identifier is a URL) and value is the HTTPS URL for the Brand's primary web presence, omitting any "www." prefix from the domain and omitting any path component. For example, since the main web presence of Boston Children's Hospital is https: //www.childrenshospital.org/, a recommended identifier would be:

          { "system": "urn:ietf:rfc:3986", "value": "https://childrenshospital.org" }


        Identifier for the organization that is used to identify the organization across multiple disparate systems.

        ShortUnique identifier for the brandIdentifies this organization across multiple systems
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..*
        This element is affected by the following invariants: org-1
        TypeIdentifier
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Organizations are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the organization.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        14. Organization.active
        Definition

        Whether the organization's record is still in active use.

        ShortWhether the organization's record is still in active use
        Comments

        This active flag is not intended to be used to mark an organization as temporarily closed or under construction. Instead the Location(s) within the Organization should have the suspended status. If further details of the reason for the suspension are required, then an extension on this element should be used.

        This element is labeled as a modifier because it may be used to mark that the resource was created in error.

        Control0..1
        Typeboolean
        Is Modifiertrue because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need a flag to indicate a record is no longer to be used and should generally be hidden for the user in the UI.

        Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        16. Organization.type
        Definition

        The kind(s) of organization that this is.

        ShortKind of organization
        Comments

        Organizations can be corporations, wards, sections, clinical teams, government departments, etc. Note that code is generally a classifier of the type of organization; in many applications, codes are used to identity a particular organization (say, ward) as opposed to another of the same type - these are identifiers, not codes

        When considering if multiple types are appropriate, you should evaluate if child organizations would be a more appropriate use of the concept, as different types likely are in different sub-areas of the organization. This is most likely to be used where type values have orthogonal values, such as a religious, academic and medical center.

        We expect that some jurisdictions will profile this optionality to be a single cardinality.

        Control0..*
        BindingFor example codes, see OrganizationTypehttp://hl7.org/fhir/ValueSet/organization-type
        (example to http://hl7.org/fhir/ValueSet/organization-type)

        Used to categorize the organization.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Need to be able to track the kind of organization that this is - different organization types have different uses.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on Organization.type. The slices are unordered and Open, and can be differentiated using the following discriminators:
        • value @ $this
        • 18. Organization.type:pab
          Slice Namepab
          Definition

          The kind(s) of organization that this is.

          ShortCategories of user access offeredKind of organization
          Comments

          Organizations can be corporations, wards, sections, clinical teams, government departments, etc. Note that code is generally a classifier of the type of organization; in many applications, codes are used to identity a particular organization (say, ward) as opposed to another of the same type - these are identifiers, not codes

          When considering if multiple types are appropriate, you should evaluate if child organizations would be a more appropriate use of the concept, as different types likely are in different sub-areas of the organization. This is most likely to be used where type values have orthogonal values, such as a religious, academic and medical center.

          We expect that some jurisdictions will profile this optionality to be a single cardinality.

          Control0..*
          BindingThe codes SHALL be taken from For example codes, see User Access Category Value Sethttp://hl7.org/fhir/ValueSet/organization-type
          (required to http://hl7.org/fhir/smart-app-launch/ValueSet/user-access-category)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

          Need to be able to track the kind of organization that this is - different organization types have different uses.

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

          The primary brand name to display on a card.


          A name associated with the organization.

          ShortPrimary brand name to display on a cardName used for the organization
          Comments

          If the name of an organization changes, consider putting the old name in the alias column so that it can still be located through searches.

          Control10..1
          This element is affected by the following invariants: org-1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          Need to use the name as the label of the organization.

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

          Aliases (e.g., former names like "Partners Healthcare") for filtering/search


          A list of alternate names that the organization is known as, or was known as in the past.

          ShortAliases (e.g., former names like "Partners Healthcare") for filtering/searchA list of alternate names that the organization is known as, or was known as in the past
          Comments

          There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the organization.

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

          Over time locations and organizations go through many changes and can be known by different names.

          For searching knowing previous names that the organization was known by can be very useful.

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

          telecom with system of url and value conveying the primary public website for the Brand. Note this is distinct from the user access portal website.


          A contact detail for the organization.

          ShortThe primary public website for the Brand.A contact detail for the organization
          Comments

          The use code 'home' is not to be used. Note that these contacts are not the contact details of people who are employed by or represent the organization, but official contacts for the organization itself.

          Control10..1*
          This element is affected by the following invariants: org-3
          TypeContactPoint
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Requirements

          Human contact for the organization.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          org-3: The telecom of an organization can never be of use 'home' (where(use = 'home').empty())
          org-3: The telecom of an organization can never be of use 'home' (where(use = 'home').empty())
          26. Organization.address
          Definition

          Locations (e.g., zip codes and/or street addresses) associated with the Brand. The following combinations are allowed, and as a best practice to ensure consistent worldwide adoption, the Address.country data element SHOULD be populated inside any of these with an ISO 3166-1 alpha-2 country code:

          • State
          • City, state
          • City, state, zip code
          • Street address, city, state, zip code
          • zip code alone

          An address for the organization.

          ShortLocations (e.g., zip codes and/or street addresses) associated with the Brand.An address for the organization
          Comments

          Organization may have multiple addresses with different uses or applicable periods. The use code 'home' is not to be used.

          Control0..*
          This element is affected by the following invariants: org-2
          TypeAddress
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Requirements

          May need to keep track of the organization's addresses for contacting, billing or reporting requirements.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          org-2: An address of an organization can never be of use 'home' (where(use = 'home').empty())
          org-2: An address of an organization can never be of use 'home' (where(use = 'home').empty())
          28. Organization.partOf
          Definition

          Affiliated "parent brand", if this Brand is part of a larger health system. "User access provided by", to convey that an affiliated Brand hosts this Brand's API technology and user portal. The hierarchy of "access provided by" links SHALL NOT exceed a depth of two (i.e., a Brand either includes portal details or links directly to a Brand that provides them).


          The organization of which this organization forms a part.

          ShortAffiliated "parent brand", if this Brand is part of a larger health systemThe organization of which this organization forms a part
          Control0..1
          TypeReference(Organization)
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

          Need to be able to track the hierarchy of organizations within an organization.

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

          References one or more UserAccessEndpoints. Endpoints here will also be listed within the organization-portal extension, to indicate the specific portal they're associated with.


          Technical endpoints providing access to services operated for the organization.

          ShortEndpoint associated with this brandTechnical endpoints providing access to services operated for the organization
          Control0..*
          TypeReference(User Access Endpoint Profile, Endpoint)bundled
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Requirements

          Organizations have multiple systems that provide various services and need to be able to define the technical connection details for how to connect to them, and for what purpose.

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

          Relative URL to an Endpoint within the User Access Brands Bundle


          A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

          ShortRelative URL to an Endpoint within the User Access Brands BundleLiteral reference, Relative, internal or absolute URL
          Comments

          Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

          Control0..1
          This element is affected by the following invariants: ref-1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

          0. Organization
          Definition

          A brand of a healthcare provider, such as a hospital, clinic, or practice

          ShortUser Access Brand
          Control0..*
          Is Modifierfalse
          Summaryfalse
          Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
          dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
          dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
          dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
          dom-6: A resource should have narrative for robust management (text.`div`.exists())
          org-1: The organization SHALL at least have a name or an identifier, and possibly more than one ((identifier.count() + name.count()) > 0)
          uab-1: Portal endpoints must also appear at Organization.endpoint (Organization.extension('http://hl7.org/fhir/StructureDefinition/organization-portal').extension('portalEndpoint').value.ofType(Reference).reference.subsetOf(%resource.endpoint.reference))
          2. Organization.id
          Definition

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

          ShortLogical id of this artifact
          Comments

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

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

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

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

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

          ShortA set of rules under which this content was created
          Comments

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

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

          The base language in which the resource is written.

          ShortLanguage of the resource content
          Comments

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

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

          A human language.

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

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

          ShortText summary of the resource, for human interpretation
          Comments

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

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

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

          ShortContained, inline Resources
          Comments

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

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

          An Extension

          ShortExtension
          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on Organization.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 16. Organization.extension:brand
            Slice Namebrand
            Definition

            Organization-level Brand information.

            ShortBrand Details
            Control0..*
            TypeExtension(Organization Brand) (Complex Extension)
            Is Modifierfalse
            Must Supporttrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            18. Organization.extension:portal
            Slice Nameportal
            Definition

            Organization-level portal information.

            ShortPortal Details
            Control0..*
            TypeExtension(Organization Portal) (Complex Extension)
            Is Modifierfalse
            Must Supporttrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            20. Organization.modifierExtension
            Definition

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

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

            ShortExtensions that cannot be ignored
            Comments

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

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

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

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

            The unique identifier for the brand that apps can use to link this Brand across publishers or with external data sets. EHRs SHALL support customer-supplied identifiers (system and value).

            • It is RECOMMENDED that each Brand include an identifier where system is urn:ietf:rfc: 3986 (meaning the identifier is a URL) and value is the HTTPS URL for the Brand's primary web presence, omitting any "www." prefix from the domain and omitting any path component. For example, since the main web presence of Boston Children's Hospital is https: //www.childrenshospital.org/, a recommended identifier would be:

              { "system": "urn:ietf:rfc:3986", "value": "https://childrenshospital.org" }

            ShortUnique identifier for the brand
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..*
            This element is affected by the following invariants: org-1
            TypeIdentifier
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Organizations are known by a variety of ids. Some institutions maintain several, and most collect identifiers for exchange with other organizations concerning the organization.

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

            Whether the organization's record is still in active use.

            ShortWhether the organization's record is still in active use
            Comments

            This active flag is not intended to be used to mark an organization as temporarily closed or under construction. Instead the Location(s) within the Organization should have the suspended status. If further details of the reason for the suspension are required, then an extension on this element should be used.

            This element is labeled as a modifier because it may be used to mark that the resource was created in error.

            Control0..1
            Typeboolean
            Is Modifiertrue because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Need a flag to indicate a record is no longer to be used and should generally be hidden for the user in the UI.

            Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            26. Organization.type
            Definition

            The kind(s) of organization that this is.

            ShortKind of organization
            Comments

            Organizations can be corporations, wards, sections, clinical teams, government departments, etc. Note that code is generally a classifier of the type of organization; in many applications, codes are used to identity a particular organization (say, ward) as opposed to another of the same type - these are identifiers, not codes

            When considering if multiple types are appropriate, you should evaluate if child organizations would be a more appropriate use of the concept, as different types likely are in different sub-areas of the organization. This is most likely to be used where type values have orthogonal values, such as a religious, academic and medical center.

            We expect that some jurisdictions will profile this optionality to be a single cardinality.

            Control0..*
            BindingFor example codes, see OrganizationType
            (example to http://hl7.org/fhir/ValueSet/organization-type)

            Used to categorize the organization.

            TypeCodeableConcept
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Need to be able to track the kind of organization that this is - different organization types have different uses.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            SlicingThis element introduces a set of slices on Organization.type. The slices are unordered and Open, and can be differentiated using the following discriminators:
            • value @ $this
            • 28. Organization.type:pab
              Slice Namepab
              Definition

              The kind(s) of organization that this is.

              ShortCategories of user access offered
              Comments

              Organizations can be corporations, wards, sections, clinical teams, government departments, etc. Note that code is generally a classifier of the type of organization; in many applications, codes are used to identity a particular organization (say, ward) as opposed to another of the same type - these are identifiers, not codes

              When considering if multiple types are appropriate, you should evaluate if child organizations would be a more appropriate use of the concept, as different types likely are in different sub-areas of the organization. This is most likely to be used where type values have orthogonal values, such as a religious, academic and medical center.

              We expect that some jurisdictions will profile this optionality to be a single cardinality.

              Control0..*
              BindingThe codes SHALL be taken from User Access Category Value Set
              (required to http://hl7.org/fhir/smart-app-launch/ValueSet/user-access-category)
              TypeCodeableConcept
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Requirements

              Need to be able to track the kind of organization that this is - different organization types have different uses.

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

              The primary brand name to display on a card.

              ShortPrimary brand name to display on a card
              Comments

              If the name of an organization changes, consider putting the old name in the alias column so that it can still be located through searches.

              Control1..1
              This element is affected by the following invariants: org-1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summarytrue
              Requirements

              Need to use the name as the label of the organization.

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

              Aliases (e.g., former names like "Partners Healthcare") for filtering/search

              ShortAliases (e.g., former names like "Partners Healthcare") for filtering/search
              Comments

              There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the organization.

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

              Over time locations and organizations go through many changes and can be known by different names.

              For searching knowing previous names that the organization was known by can be very useful.

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

              telecom with system of url and value conveying the primary public website for the Brand. Note this is distinct from the user access portal website.

              ShortThe primary public website for the Brand.
              Comments

              The use code 'home' is not to be used. Note that these contacts are not the contact details of people who are employed by or represent the organization, but official contacts for the organization itself.

              Control1..1
              This element is affected by the following invariants: org-3
              TypeContactPoint
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Requirements

              Human contact for the organization.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              org-3: The telecom of an organization can never be of use 'home' (where(use = 'home').empty())
              36. Organization.address
              Definition

              Locations (e.g., zip codes and/or street addresses) associated with the Brand. The following combinations are allowed, and as a best practice to ensure consistent worldwide adoption, the Address.country data element SHOULD be populated inside any of these with an ISO 3166-1 alpha-2 country code:

              • State
              • City, state
              • City, state, zip code
              • Street address, city, state, zip code
              • zip code alone
              ShortLocations (e.g., zip codes and/or street addresses) associated with the Brand.
              Comments

              Organization may have multiple addresses with different uses or applicable periods. The use code 'home' is not to be used.

              Control0..*
              This element is affected by the following invariants: org-2
              TypeAddress
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Requirements

              May need to keep track of the organization's addresses for contacting, billing or reporting requirements.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              org-2: An address of an organization can never be of use 'home' (where(use = 'home').empty())
              38. Organization.partOf
              Definition

              Affiliated "parent brand", if this Brand is part of a larger health system. "User access provided by", to convey that an affiliated Brand hosts this Brand's API technology and user portal. The hierarchy of "access provided by" links SHALL NOT exceed a depth of two (i.e., a Brand either includes portal details or links directly to a Brand that provides them).

              ShortAffiliated "parent brand", if this Brand is part of a larger health system
              Control0..1
              TypeReference(Organization)
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Requirements

              Need to be able to track the hierarchy of organizations within an organization.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              40. Organization.contact
              Definition

              Contact for the organization for a certain purpose.

              ShortContact for the organization for a certain purpose
              Comments

              Where multiple contacts for the same purpose are provided there is a standard extension that can be used to determine which one is the preferred contact to use.

              Control0..*
              TypeBackboneElement
              Is Modifierfalse
              Summaryfalse
              Requirements

              Need to keep track of assigned contact points within bigger organization.

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

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

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

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

              ShortAdditional content defined by implementations
              Comments

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

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

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

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

              ShortExtensions that cannot be ignored even if unrecognized
              Comments

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

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

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

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

              Indicates a purpose for which the contact can be reached.

              ShortThe type of contact
              Control0..1
              BindingUnless not suitable, these codes SHALL be taken from ContactEntityType
              (extensible to http://hl7.org/fhir/ValueSet/contactentity-type)

              The purpose for which you would contact a contact party.

              TypeCodeableConcept
              Is Modifierfalse
              Summaryfalse
              Requirements

              Need to distinguish between multiple contact persons.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              50. Organization.contact.name
              Definition

              A name associated with the contact.

              ShortA name associated with the contact
              Control0..1
              TypeHumanName
              Is Modifierfalse
              Summaryfalse
              Requirements

              Need to be able to track the person by name.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              52. Organization.contact.telecom
              Definition

              A contact detail (e.g. a telephone number or an email address) by which the party may be contacted.

              ShortContact details (telephone, email, etc.) for a contact
              Control0..*
              TypeContactPoint
              Is Modifierfalse
              Summaryfalse
              Requirements

              People have (primary) ways to contact them in some way such as phone, email.

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

              Visiting or postal addresses for the contact.

              ShortVisiting or postal addresses for the contact
              Control0..1
              TypeAddress
              Is Modifierfalse
              Summaryfalse
              Requirements

              May need to keep track of a contact party's address for contacting, billing or reporting requirements.

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

              References one or more UserAccessEndpoints. Endpoints here will also be listed within the organization-portal extension, to indicate the specific portal they're associated with.

              ShortEndpoint associated with this brand
              Control0..*
              TypeReference(User Access Endpoint Profile)bundled
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Requirements

              Organizations have multiple systems that provide various services and need to be able to define the technical connection details for how to connect to them, and for what purpose.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              58. Organization.endpoint.id
              Definition

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

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

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

              ShortAdditional content defined by implementations
              Comments

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

              Control0..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on Organization.endpoint.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 62. Organization.endpoint.reference
                Definition

                Relative URL to an Endpoint within the User Access Brands Bundle

                ShortRelative URL to an Endpoint within the User Access Brands Bundle
                Comments

                Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                Control0..1
                This element is affected by the following invariants: ref-1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                64. Organization.endpoint.type
                Definition

                The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                ShortType the reference refers to (e.g. "Patient")
                Comments

                This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                Control0..1
                BindingUnless not suitable, these codes SHALL be taken from ResourceType
                (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                Aa resource (or, for logical models, the URI of the logical model).

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

                An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                ShortLogical reference, when literal reference is not known
                Comments

                When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control0..1
                TypeIdentifier
                Is Modifierfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                68. Organization.endpoint.display
                Definition

                Plain text narrative that identifies the resource in addition to the resource reference.

                ShortText alternative for the resource
                Comments

                This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                Control0..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))