Birth And Fetal Death (BFDR) FHIR Implementation Guide
2.0.0 - STU2 United States of America flag

This page is part of the Vital Records Birth and Fetal Death Reporting (v2.0.0: STU2) 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: CompositionCodedRaceAndEthnicity - Detailed Descriptions

Active as of 2024-10-15

Definitions for the Composition-coded-race-and-ethnicity resource profile.

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

0. Composition
2. Composition.type
Definition

Race and ethnicity information Document

ShortRace and ethnicity information Document
Pattern Value{
  "coding" : [{
    "system" : "http://loinc.org",
    "code" : "86805-9"
  }]
}
4. Composition.subject
TypeReference(Patient - Child Vital Records, Patient - Decedent Fetus)
6. Composition.author
Definition

The author is the NCHS.

ShortThe author is the NCHS.
Control0..1
8. Composition.section
Definition

The Composition is broken into sections where each section includes the input and output race and ethnicity for one individual.

ShortThe Composition is broken into sections, where each section includes the input and output race and ethnicity for one individual.
Control1..2
SlicingThis element introduces a set of slices on Composition.section. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • pattern @ code
  • 10. Composition.section:mother
    Slice Namemother
    Definition

    mother

    Shortmother Section on the Race and Ethnicity - Mother Report
    Control0..1
    12. Composition.section:mother.code
    Control1..?
    Pattern Value{
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
        "code" : "MTH"
      }]
    }
    14. Composition.section:mother.entry
    Definition

    Entries that are contained in the mother Section

    ShortEntries that are contained in the mother Section
    SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • profile @ $this.resolve()
    • 16. Composition.section:mother.entry:motherPatient
      Slice NamemotherPatient
      Definition

      PatientMotherVitalRecordsNew

      ShortMother
      Control0..1
      TypeReference(Patient - Mother Vital Records)
      18. Composition.section:mother.entry:inputRaceAndEthnicity
      Slice NameinputRaceAndEthnicity
      Definition

      InputRaceAndEthnicity

      ShortInput Race And Ethnicity
      Control0..1
      TypeReference(Observation - Input Race and Ethnicity Vital Records)
      20. Composition.section:mother.entry:codedRaceAndEthnicity
      Slice NamecodedRaceAndEthnicity
      Definition

      Coded Race And Ethnicity

      ShortCoded Race And Ethnicity
      Control0..1
      TypeReference(Observation - Coded Race and Ethnicity Vital Records)
      22. Composition.section:father
      Slice Namefather
      Definition

      father

      Shortfather Section on the Race and Ethnicity - Father Report
      Control0..1
      24. Composition.section:father.code
      Control1..?
      Pattern Value{
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
          "code" : "NFTH"
        }]
      }
      26. Composition.section:father.entry
      Definition

      Entries that are contained in the father Section

      ShortEntries that are contained in the father Section
      SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • profile @ $this.resolve()
      • 28. Composition.section:father.entry:fatherPatient
        Slice NamefatherPatient
        Definition

        Father

        ShortFather
        Control0..1
        TypeReference(Related Person - Parent Vital Records)
        30. Composition.section:father.entry:inputRaceAndEthnicity
        Slice NameinputRaceAndEthnicity
        Definition

        InputRaceAndEthnicity

        ShortInput Race And Ethnicity
        Control0..1
        TypeReference(Observation - Input Race and Ethnicity Vital Records)
        32. Composition.section:father.entry:codedRaceAndEthnicity
        Slice NamecodedRaceAndEthnicity
        Definition

        Coded Race And Ethnicity

        ShortCoded Race And Ethnicity
        Control0..1
        TypeReference(Observation - Coded Race and Ethnicity Vital Records)

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

        0. Composition
        Definition

        A set of healthcare-related information that is assembled together into a single logical package that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. A Composition defines the structure and narrative content necessary for a document. However, a Composition alone does not constitute a document. Rather, the Composition must be the first entry in a Bundle where Bundle.type=document, and any other resources referenced from Composition must be included as subsequent entries in the Bundle (for example Patient, Practitioner, Encounter, etc.).

        ShortA set of resources composed into a single coherent clinical statement with clinical attestation
        Comments

        While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical.

        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())
        2. Composition.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. Composition.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())
        6. Composition.status
        Definition

        The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.

        Shortpreliminary | final | amended | entered-in-error
        Comments

        If a composition is marked as withdrawn, the compositions/documents in the series, or data from the composition or document series, should never be displayed to a user without being clearly marked as untrustworthy. The flag "entered-in-error" is why this element is labeled as a modifier of other elements.

        Some reporting work flows require that the original narrative of a final document never be altered; instead, only new narrative can be added. The composition resource has no explicit status for explicitly noting whether this business rule is in effect. This would be handled by an extension if required.

        Control1..1
        BindingThe codes SHALL be taken from CompositionStatushttp://hl7.org/fhir/ValueSet/composition-status|4.0.1
        (required to http://hl7.org/fhir/ValueSet/composition-status|4.0.1)

        The workflow/clinical status of the composition.

        Typecode
        Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need to be able to mark interim, amended, or withdrawn compositions or documents.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        8. Composition.type
        Definition

        Race and ethnicity information Document


        Specifies the particular kind of composition (e.g. History and Physical, Discharge Summary, Progress Note). This usually equates to the purpose of making the composition.

        ShortRace and ethnicity information DocumentKind of composition (LOINC if possible)
        Comments

        For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation guides will require a specific LOINC code, or use LOINC as an extensible binding.

        Control1..1
        BindingThe codes SHOULD be taken from FHIRDocumentTypeCodeshttp://hl7.org/fhir/ValueSet/doc-typecodes
        (preferred to http://hl7.org/fhir/ValueSet/doc-typecodes)

        Type of a composition.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Requirements

        Key metadata element describing the composition, used in searching/filtering.

        Pattern Value{
          "coding" : [{
            "system" : "http://loinc.org",
            "code" : "86805-9"
          }]
        }
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        10. Composition.subject
        Definition

        Who or what the composition is about. The composition can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure).

        ShortWho and/or what the composition is about
        Comments

        For clinical documents, this is usually the patient.

        Control0..1
        TypeReference(Patient - Child Vital Records, Patient - Decedent Fetus, Resource)
        Is Modifierfalse
        Summarytrue
        Requirements

        Essential metadata for searching for the composition. Identifies who and/or what the composition/document is about.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        12. Composition.date
        Definition

        The composition editing time, when the composition was last logically changed by the author.

        ShortComposition editing time
        Comments

        The Last Modified Date on the composition may be after the date of the document was attested without being changed.

        Control1..1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring. When packaged in a document, Bundle.timestamp is the date of packaging.


        dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring. When packaged in a document, Bundle.timestamp is the date of packaging.

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

        The author is the NCHS.


        Identifies who is responsible for the information in the composition, not necessarily who typed it in.

        ShortThe author is the NCHS.Who and/or what authored the composition
        Control1..1*
        TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
        Is Modifierfalse
        Summarytrue
        Requirements

        Identifies who is responsible for the content.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        16. Composition.title
        Definition

        Official human-readable label for the composition.

        ShortHuman Readable name/title
        Comments

        For many compositions, the title is the same as the text or a display name of Composition.type (e.g. a "consultation" or "progress note"). Note that CDA does not make title mandatory, but there are no known cases where it is useful for title to be omitted, so it is mandatory here. Feedback on this requirement is welcome during the trial use period.

        Control1..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()))
        18. Composition.section
        Definition

        The Composition is broken into sections where each section includes the input and output race and ethnicity for one individual.


        The root of the sections that make up the composition.

        ShortThe Composition is broken into sections, where each section includes the input and output race and ethnicity for one individual.Composition is broken into sections
        Control10..2*
        TypeBackboneElement
        Is Modifierfalse
        Summaryfalse
        Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
        cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
        cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
        SlicingThis element introduces a set of slices on Composition.section. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • pattern @ code
        • 20. Composition.section.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())
          22. Composition.section:mother
          Slice Namemother
          Definition

          mother


          The root of the sections that make up the composition.

          Shortmother Section on the Race and Ethnicity - Mother ReportComposition is broken into sections
          Control0..1*
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
          24. Composition.section:mother.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())
          26. Composition.section:mother.code
          Definition

          A code identifying the kind of content contained within the section. This must be consistent with the section title.

          ShortClassification of section (recommended)
          Comments

          The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

          If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

          Control10..1
          BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
          (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

          Classification of a section of a composition/document.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Requirements

          Provides computable standardized labels to topics within the document.

          Pattern Value{
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
              "code" : "MTH"
            }]
          }
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          28. Composition.section:mother.entry
          Definition

          Entries that are contained in the mother Section


          A reference to the actual resource from which the narrative in the section is derived.

          ShortEntries that are contained in the mother SectionA reference to data that supports this section
          Comments

          If there are no entries in the list, an emptyReason SHOULD be provided.

          Control0..*
          This element is affected by the following invariants: cmp-2
          TypeReference(Resource)
          Is Modifierfalse
          Summaryfalse
          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 Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • profile @ $this.resolve()
          • 30. Composition.section:mother.entry:motherPatient
            Slice NamemotherPatient
            Definition

            PatientMotherVitalRecordsNew


            A reference to the actual resource from which the narrative in the section is derived.

            ShortMotherA reference to data that supports this section
            Comments

            If there are no entries in the list, an emptyReason SHOULD be provided.

            Control0..1*
            This element is affected by the following invariants: cmp-2
            TypeReference(Patient - Mother Vital Records, Resource)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            32. Composition.section:mother.entry:inputRaceAndEthnicity
            Slice NameinputRaceAndEthnicity
            Definition

            InputRaceAndEthnicity


            A reference to the actual resource from which the narrative in the section is derived.

            ShortInput Race And EthnicityA reference to data that supports this section
            Comments

            If there are no entries in the list, an emptyReason SHOULD be provided.

            Control0..1*
            This element is affected by the following invariants: cmp-2
            TypeReference(Observation - Input Race and Ethnicity Vital Records, Resource)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            34. Composition.section:mother.entry:codedRaceAndEthnicity
            Slice NamecodedRaceAndEthnicity
            Definition

            Coded Race And Ethnicity


            A reference to the actual resource from which the narrative in the section is derived.

            ShortCoded Race And EthnicityA reference to data that supports this section
            Comments

            If there are no entries in the list, an emptyReason SHOULD be provided.

            Control0..1*
            This element is affected by the following invariants: cmp-2
            TypeReference(Observation - Coded Race and Ethnicity Vital Records, Resource)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            36. Composition.section:father
            Slice Namefather
            Definition

            father


            The root of the sections that make up the composition.

            Shortfather Section on the Race and Ethnicity - Father ReportComposition is broken into sections
            Control0..1*
            TypeBackboneElement
            Is Modifierfalse
            Summaryfalse
            Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
            38. Composition.section:father.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())
            40. Composition.section:father.code
            Definition

            A code identifying the kind of content contained within the section. This must be consistent with the section title.

            ShortClassification of section (recommended)
            Comments

            The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

            If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

            Control10..1
            BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
            (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

            Classification of a section of a composition/document.

            TypeCodeableConcept
            Is Modifierfalse
            Summaryfalse
            Requirements

            Provides computable standardized labels to topics within the document.

            Pattern Value{
              "coding" : [{
                "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
                "code" : "NFTH"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            42. Composition.section:father.entry
            Definition

            Entries that are contained in the father Section


            A reference to the actual resource from which the narrative in the section is derived.

            ShortEntries that are contained in the father SectionA reference to data that supports this section
            Comments

            If there are no entries in the list, an emptyReason SHOULD be provided.

            Control0..*
            This element is affected by the following invariants: cmp-2
            TypeReference(Resource)
            Is Modifierfalse
            Summaryfalse
            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 Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • profile @ $this.resolve()
            • 44. Composition.section:father.entry:fatherPatient
              Slice NamefatherPatient
              Definition

              Father


              A reference to the actual resource from which the narrative in the section is derived.

              ShortFatherA reference to data that supports this section
              Comments

              If there are no entries in the list, an emptyReason SHOULD be provided.

              Control0..1*
              This element is affected by the following invariants: cmp-2
              TypeReference(Related Person - Parent Vital Records, Resource)
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              46. Composition.section:father.entry:inputRaceAndEthnicity
              Slice NameinputRaceAndEthnicity
              Definition

              InputRaceAndEthnicity


              A reference to the actual resource from which the narrative in the section is derived.

              ShortInput Race And EthnicityA reference to data that supports this section
              Comments

              If there are no entries in the list, an emptyReason SHOULD be provided.

              Control0..1*
              This element is affected by the following invariants: cmp-2
              TypeReference(Observation - Input Race and Ethnicity Vital Records, Resource)
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              48. Composition.section:father.entry:codedRaceAndEthnicity
              Slice NamecodedRaceAndEthnicity
              Definition

              Coded Race And Ethnicity


              A reference to the actual resource from which the narrative in the section is derived.

              ShortCoded Race And EthnicityA reference to data that supports this section
              Comments

              If there are no entries in the list, an emptyReason SHOULD be provided.

              Control0..1*
              This element is affected by the following invariants: cmp-2
              TypeReference(Observation - Coded Race and Ethnicity Vital Records, Resource)
              Is Modifierfalse
              Summaryfalse
              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. Composition
              Definition

              A set of healthcare-related information that is assembled together into a single logical package that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. A Composition defines the structure and narrative content necessary for a document. However, a Composition alone does not constitute a document. Rather, the Composition must be the first entry in a Bundle where Bundle.type=document, and any other resources referenced from Composition must be included as subsequent entries in the Bundle (for example Patient, Practitioner, Encounter, etc.).

              ShortA set of resources composed into a single coherent clinical statement with clinical attestation
              Comments

              While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical.

              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())
              2. Composition.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. Composition.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. Composition.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. Composition.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. Composition.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. Composition.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. Composition.extension
              Definition

              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.

              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())
              16. Composition.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())
              18. Composition.identifier
              Definition

              A version-independent identifier for the Composition. This identifier stays constant as the composition is changed over time.

              ShortVersion-independent identifier for the Composition
              Comments

              Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate.

              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()))
              20. Composition.status
              Definition

              The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.

              Shortpreliminary | final | amended | entered-in-error
              Comments

              If a composition is marked as withdrawn, the compositions/documents in the series, or data from the composition or document series, should never be displayed to a user without being clearly marked as untrustworthy. The flag "entered-in-error" is why this element is labeled as a modifier of other elements.

              Some reporting work flows require that the original narrative of a final document never be altered; instead, only new narrative can be added. The composition resource has no explicit status for explicitly noting whether this business rule is in effect. This would be handled by an extension if required.

              Control1..1
              BindingThe codes SHALL be taken from CompositionStatus
              (required to http://hl7.org/fhir/ValueSet/composition-status|4.0.1)

              The workflow/clinical status of the composition.

              Typecode
              Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              Need to be able to mark interim, amended, or withdrawn compositions or documents.

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

              Race and ethnicity information Document

              ShortRace and ethnicity information Document
              Comments

              For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation guides will require a specific LOINC code, or use LOINC as an extensible binding.

              Control1..1
              BindingThe codes SHOULD be taken from FHIRDocumentTypeCodes
              (preferred to http://hl7.org/fhir/ValueSet/doc-typecodes)

              Type of a composition.

              TypeCodeableConcept
              Is Modifierfalse
              Summarytrue
              Requirements

              Key metadata element describing the composition, used in searching/filtering.

              Pattern Value{
                "coding" : [{
                  "system" : "http://loinc.org",
                  "code" : "86805-9"
                }]
              }
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              24. Composition.category
              Definition

              A categorization for the type of the composition - helps for indexing and searching. This may be implied by or derived from the code specified in the Composition Type.

              ShortCategorization of Composition
              Comments

              This is a metadata field from XDS/MHD.

              Control0..*
              BindingFor example codes, see DocumentClassValueSet
              (example to http://hl7.org/fhir/ValueSet/document-classcodes)

              High-level kind of a clinical document at a macro level.

              TypeCodeableConcept
              Is Modifierfalse
              Summarytrue
              Requirements

              Helps humans to assess whether the composition is of interest when viewing an index of compositions or documents.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              26. Composition.subject
              Definition

              Who or what the composition is about. The composition can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure).

              ShortWho and/or what the composition is about
              Comments

              For clinical documents, this is usually the patient.

              Control0..1
              TypeReference(Patient - Child Vital Records, Patient - Decedent Fetus)
              Is Modifierfalse
              Summarytrue
              Requirements

              Essential metadata for searching for the composition. Identifies who and/or what the composition/document is about.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              28. Composition.encounter
              Definition

              Describes the clinical encounter or type of care this documentation is associated with.

              ShortContext of the Composition
              Control0..1
              TypeReference(Encounter)
              Is Modifierfalse
              Summarytrue
              Requirements

              Provides context for the composition and supports searching.

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

              The composition editing time, when the composition was last logically changed by the author.

              ShortComposition editing time
              Comments

              The Last Modified Date on the composition may be after the date of the document was attested without being changed.

              Control1..1
              TypedateTime
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring. When packaged in a document, Bundle.timestamp is the date of packaging.

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

              The author is the NCHS.

              ShortThe author is the NCHS.
              Control1..1
              TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
              Is Modifierfalse
              Summarytrue
              Requirements

              Identifies who is responsible for the content.

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

              Official human-readable label for the composition.

              ShortHuman Readable name/title
              Comments

              For many compositions, the title is the same as the text or a display name of Composition.type (e.g. a "consultation" or "progress note"). Note that CDA does not make title mandatory, but there are no known cases where it is useful for title to be omitted, so it is mandatory here. Feedback on this requirement is welcome during the trial use period.

              Control1..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()))
              36. Composition.confidentiality
              Definition

              The code specifying the level of confidentiality of the Composition.

              ShortAs defined by affinity domain
              Comments

              The exact use of this element, and enforcement and issues related to highly sensitive documents are out of scope for the base specification, and delegated to implementation profiles (see security section). This element is labeled as a modifier because highly confidential documents must not be treated as if they are not.

              Control0..1
              BindingThe codes SHALL be taken from v3.ConfidentialityClassification (2014-03-26)
              (required to http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26)

              Codes specifying the level of confidentiality of the composition.

              Typecode
              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()))
              38. Composition.attester
              Definition

              A participant who has attested to the accuracy of the composition/document.

              ShortAttests to accuracy of composition
              Comments

              Only list each attester once.

              Control0..*
              TypeBackboneElement
              Is Modifierfalse
              Summaryfalse
              Requirements

              Identifies responsibility for the accuracy of the composition content.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              40. Composition.attester.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
              42. Composition.attester.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())
              44. Composition.attester.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())
              46. Composition.attester.mode
              Definition

              The type of attestation the authenticator offers.

              Shortpersonal | professional | legal | official
              Control1..1
              BindingThe codes SHALL be taken from CompositionAttestationMode
              (required to http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1)

              The way in which a person authenticated a composition.

              Typecode
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summaryfalse
              Requirements

              Indicates the level of authority of the attestation.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              48. Composition.attester.time
              Definition

              When the composition was attested by the party.

              ShortWhen the composition was attested
              Control0..1
              TypedateTime
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summaryfalse
              Requirements

              Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              50. Composition.attester.party
              Definition

              Who attested the composition in the specified way.

              ShortWho attested the composition
              Control0..1
              TypeReference(Patient, RelatedPerson, Practitioner, PractitionerRole, Organization)
              Is Modifierfalse
              Summaryfalse
              Requirements

              Identifies who has taken on the responsibility for accuracy of the composition content.

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

              Identifies the organization or group who is responsible for ongoing maintenance of and access to the composition/document information.

              ShortOrganization which maintains the composition
              Comments

              This is useful when documents are derived from a composition - provides guidance for how to get the latest version of the document. This is optional because this is sometimes not known by the authoring system, and can be inferred by context. However, it is important that this information be known when working with a derived document, so providing a custodian is encouraged.

              Control0..1
              TypeReference(Organization)
              Is Modifierfalse
              Summarytrue
              Requirements

              Identifies where to go to find the current version, where to report issues, etc.

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

              Relationships that this composition has with other compositions or documents that already exist.

              ShortRelationships to other compositions/documents
              Comments

              A document is a version specific composition.

              Control0..*
              TypeBackboneElement
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              56. Composition.relatesTo.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
              58. Composition.relatesTo.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())
              60. Composition.relatesTo.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())
              62. Composition.relatesTo.code
              Definition

              The type of relationship that this composition has with anther composition or document.

              Shortreplaces | transforms | signs | appends
              Comments

              If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.

              Control1..1
              BindingThe codes SHALL be taken from DocumentRelationshipType
              (required to http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1)

              The type of relationship between documents.

              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()))
              64. Composition.relatesTo.target[x]
              Definition

              The target composition/document of this relationship.

              ShortTarget of the relationship
              Control1..1
              TypeChoice of: Identifier, Reference(Composition)
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              66. Composition.event
              Definition

              The clinical service, such as a colonoscopy or an appendectomy, being documented.

              ShortThe clinical service(s) being documented
              Comments

              The event needs to be consistent with the type element, though can provide further information if desired.

              Control0..*
              TypeBackboneElement
              Is Modifierfalse
              Summarytrue
              Requirements

              Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              68. Composition.event.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
              70. Composition.event.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())
              72. Composition.event.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())
              74. Composition.event.code
              Definition

              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.

              ShortCode(s) that apply to the event being documented
              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.

              Control0..*
              BindingFor example codes, see v3 Code System ActCode
              (example to http://terminology.hl7.org/ValueSet/v3-ActCode)

              This list of codes represents the main clinical acts being documented.

              TypeCodeableConcept
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              76. Composition.event.period
              Definition

              The period of time covered by the documentation. There is no assertion that the documentation is a complete representation for this period, only that it documents events during this time.

              ShortThe period covered by the documentation
              Control0..1
              TypePeriod
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              78. Composition.event.detail
              Definition

              The description and/or reference of the event(s) being documented. For example, this could be used to document such a colonoscopy or an appendectomy.

              ShortThe event(s) being documented
              Control0..*
              TypeReference(Resource)
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              80. Composition.section
              Definition

              The Composition is broken into sections where each section includes the input and output race and ethnicity for one individual.

              ShortThe Composition is broken into sections, where each section includes the input and output race and ethnicity for one individual.
              Control1..2
              TypeBackboneElement
              Is Modifierfalse
              Summaryfalse
              Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              SlicingThis element introduces a set of slices on Composition.section. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • pattern @ code
              • 82. Composition.section.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
                84. Composition.section.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())
                86. Composition.section.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())
                88. Composition.section.title
                Definition

                The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                ShortLabel for section (e.g. for ToC)
                Comments

                The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                Control0..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summaryfalse
                Requirements

                Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                Alternate Namesheader, label, caption
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                90. Composition.section.code
                Definition

                A code identifying the kind of content contained within the section. This must be consistent with the section title.

                ShortClassification of section (recommended)
                Comments

                The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                Control0..1
                BindingFor example codes, see DocumentSectionCodes
                (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                Classification of a section of a composition/document.

                TypeCodeableConcept
                Is Modifierfalse
                Summaryfalse
                Requirements

                Provides computable standardized labels to topics within the document.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                92. Composition.section.author
                Definition

                Identifies who is responsible for the information in this section, not necessarily who typed it in.

                ShortWho and/or what authored the section
                Control0..*
                TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                Is Modifierfalse
                Summaryfalse
                Requirements

                Identifies who is responsible for the content.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                94. Composition.section.focus
                Definition

                The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                ShortWho/what the section is about, when it is not about the subject of composition
                Comments

                Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                Control0..1
                TypeReference(Resource)
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                96. Composition.section.text
                Definition

                A human-readable narrative that contains the attested content of the section, 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.

                ShortText summary of the section, for human interpretation
                Comments

                Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                Control0..1
                This element is affected by the following invariants: cmp-1
                TypeNarrative
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                98. Composition.section.mode
                Definition

                How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                Shortworking | snapshot | changes
                Comments

                This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                Control0..1
                BindingThe codes SHALL be taken from ListMode
                (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                The processing mode that applies to this section.

                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summaryfalse
                Requirements

                Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                100. Composition.section.orderedBy
                Definition

                Specifies the order applied to the items in the section entries.

                ShortOrder of section entries
                Comments

                Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                Control0..1
                BindingThe codes SHOULD be taken from ListOrderCodes
                (preferred to http://hl7.org/fhir/ValueSet/list-order)

                What order applies to the items in the entry.

                TypeCodeableConcept
                Is Modifierfalse
                Summaryfalse
                Requirements

                Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                102. Composition.section.entry
                Definition

                A reference to the actual resource from which the narrative in the section is derived.

                ShortA reference to data that supports this section
                Comments

                If there are no entries in the list, an emptyReason SHOULD be provided.

                Control0..*
                This element is affected by the following invariants: cmp-2
                TypeReference(Resource)
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                104. Composition.section.emptyReason
                Definition

                If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                ShortWhy the section is empty
                Comments

                The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                Control0..1
                This element is affected by the following invariants: cmp-2
                BindingThe codes SHOULD be taken from ListEmptyReasons
                (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                If a section is empty, why it is empty.

                TypeCodeableConcept
                Is Modifierfalse
                Summaryfalse
                Requirements

                Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                106. Composition.section.section
                Definition

                A nested sub-section within this section.

                ShortNested Section
                Comments

                Nested sections are primarily used to help human readers navigate to particular portions of the document.

                Control0..*
                This element is affected by the following invariants: cmp-1
                TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                108. Composition.section:mother
                Slice Namemother
                Definition

                mother

                Shortmother Section on the Race and Ethnicity - Mother Report
                Control0..1
                TypeBackboneElement
                Is Modifierfalse
                Summaryfalse
                Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                110. Composition.section:mother.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
                112. Composition.section:mother.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())
                114. Composition.section:mother.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())
                116. Composition.section:mother.title
                Definition

                The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                ShortLabel for section (e.g. for ToC)
                Comments

                The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                Control0..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summaryfalse
                Requirements

                Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                Alternate Namesheader, label, caption
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                118. Composition.section:mother.code
                Definition

                A code identifying the kind of content contained within the section. This must be consistent with the section title.

                ShortClassification of section (recommended)
                Comments

                The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                Control1..1
                BindingFor example codes, see DocumentSectionCodes
                (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                Classification of a section of a composition/document.

                TypeCodeableConcept
                Is Modifierfalse
                Summaryfalse
                Requirements

                Provides computable standardized labels to topics within the document.

                Pattern Value{
                  "coding" : [{
                    "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
                    "code" : "MTH"
                  }]
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                120. Composition.section:mother.author
                Definition

                Identifies who is responsible for the information in this section, not necessarily who typed it in.

                ShortWho and/or what authored the section
                Control0..*
                TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                Is Modifierfalse
                Summaryfalse
                Requirements

                Identifies who is responsible for the content.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                122. Composition.section:mother.focus
                Definition

                The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                ShortWho/what the section is about, when it is not about the subject of composition
                Comments

                Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                Control0..1
                TypeReference(Resource)
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                124. Composition.section:mother.text
                Definition

                A human-readable narrative that contains the attested content of the section, 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.

                ShortText summary of the section, for human interpretation
                Comments

                Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                Control0..1
                This element is affected by the following invariants: cmp-1
                TypeNarrative
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                126. Composition.section:mother.mode
                Definition

                How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                Shortworking | snapshot | changes
                Comments

                This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                Control0..1
                BindingThe codes SHALL be taken from ListMode
                (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                The processing mode that applies to this section.

                Typecode
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summaryfalse
                Requirements

                Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                128. Composition.section:mother.orderedBy
                Definition

                Specifies the order applied to the items in the section entries.

                ShortOrder of section entries
                Comments

                Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                Control0..1
                BindingThe codes SHOULD be taken from ListOrderCodes
                (preferred to http://hl7.org/fhir/ValueSet/list-order)

                What order applies to the items in the entry.

                TypeCodeableConcept
                Is Modifierfalse
                Summaryfalse
                Requirements

                Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                130. Composition.section:mother.entry
                Definition

                Entries that are contained in the mother Section

                ShortEntries that are contained in the mother Section
                Comments

                If there are no entries in the list, an emptyReason SHOULD be provided.

                Control0..*
                This element is affected by the following invariants: cmp-2
                TypeReference(Resource)
                Is Modifierfalse
                Summaryfalse
                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 Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • profile @ $this.resolve()
                • 132. Composition.section:mother.entry:motherPatient
                  Slice NamemotherPatient
                  Definition

                  PatientMotherVitalRecordsNew

                  ShortMother
                  Comments

                  If there are no entries in the list, an emptyReason SHOULD be provided.

                  Control0..1
                  This element is affected by the following invariants: cmp-2
                  TypeReference(Patient - Mother Vital Records)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  134. Composition.section:mother.entry:inputRaceAndEthnicity
                  Slice NameinputRaceAndEthnicity
                  Definition

                  InputRaceAndEthnicity

                  ShortInput Race And Ethnicity
                  Comments

                  If there are no entries in the list, an emptyReason SHOULD be provided.

                  Control0..1
                  This element is affected by the following invariants: cmp-2
                  TypeReference(Observation - Input Race and Ethnicity Vital Records)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  136. Composition.section:mother.entry:codedRaceAndEthnicity
                  Slice NamecodedRaceAndEthnicity
                  Definition

                  Coded Race And Ethnicity

                  ShortCoded Race And Ethnicity
                  Comments

                  If there are no entries in the list, an emptyReason SHOULD be provided.

                  Control0..1
                  This element is affected by the following invariants: cmp-2
                  TypeReference(Observation - Coded Race and Ethnicity Vital Records)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  138. Composition.section:mother.emptyReason
                  Definition

                  If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                  ShortWhy the section is empty
                  Comments

                  The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                  Control0..1
                  This element is affected by the following invariants: cmp-2
                  BindingThe codes SHOULD be taken from ListEmptyReasons
                  (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                  If a section is empty, why it is empty.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summaryfalse
                  Requirements

                  Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  140. Composition.section:mother.section
                  Definition

                  A nested sub-section within this section.

                  ShortNested Section
                  Comments

                  Nested sections are primarily used to help human readers navigate to particular portions of the document.

                  Control0..*
                  This element is affected by the following invariants: cmp-1
                  TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  142. Composition.section:father
                  Slice Namefather
                  Definition

                  father

                  Shortfather Section on the Race and Ethnicity - Father Report
                  Control0..1
                  TypeBackboneElement
                  Is Modifierfalse
                  Summaryfalse
                  Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                  cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                  ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  144. Composition.section:father.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
                  146. Composition.section:father.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())
                  148. Composition.section:father.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())
                  150. Composition.section:father.title
                  Definition

                  The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                  ShortLabel for section (e.g. for ToC)
                  Comments

                  The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Requirements

                  Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                  Alternate Namesheader, label, caption
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  152. Composition.section:father.code
                  Definition

                  A code identifying the kind of content contained within the section. This must be consistent with the section title.

                  ShortClassification of section (recommended)
                  Comments

                  The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                  If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                  Control1..1
                  BindingFor example codes, see DocumentSectionCodes
                  (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                  Classification of a section of a composition/document.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summaryfalse
                  Requirements

                  Provides computable standardized labels to topics within the document.

                  Pattern Value{
                    "coding" : [{
                      "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
                      "code" : "NFTH"
                    }]
                  }
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  154. Composition.section:father.author
                  Definition

                  Identifies who is responsible for the information in this section, not necessarily who typed it in.

                  ShortWho and/or what authored the section
                  Control0..*
                  TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                  Is Modifierfalse
                  Summaryfalse
                  Requirements

                  Identifies who is responsible for the content.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  156. Composition.section:father.focus
                  Definition

                  The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                  ShortWho/what the section is about, when it is not about the subject of composition
                  Comments

                  Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                  Control0..1
                  TypeReference(Resource)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  158. Composition.section:father.text
                  Definition

                  A human-readable narrative that contains the attested content of the section, 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.

                  ShortText summary of the section, for human interpretation
                  Comments

                  Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                  Control0..1
                  This element is affected by the following invariants: cmp-1
                  TypeNarrative
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  160. Composition.section:father.mode
                  Definition

                  How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                  Shortworking | snapshot | changes
                  Comments

                  This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                  Control0..1
                  BindingThe codes SHALL be taken from ListMode
                  (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                  The processing mode that applies to this section.

                  Typecode
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Requirements

                  Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  162. Composition.section:father.orderedBy
                  Definition

                  Specifies the order applied to the items in the section entries.

                  ShortOrder of section entries
                  Comments

                  Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                  Control0..1
                  BindingThe codes SHOULD be taken from ListOrderCodes
                  (preferred to http://hl7.org/fhir/ValueSet/list-order)

                  What order applies to the items in the entry.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summaryfalse
                  Requirements

                  Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  164. Composition.section:father.entry
                  Definition

                  Entries that are contained in the father Section

                  ShortEntries that are contained in the father Section
                  Comments

                  If there are no entries in the list, an emptyReason SHOULD be provided.

                  Control0..*
                  This element is affected by the following invariants: cmp-2
                  TypeReference(Resource)
                  Is Modifierfalse
                  Summaryfalse
                  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 Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • profile @ $this.resolve()
                  • 166. Composition.section:father.entry:fatherPatient
                    Slice NamefatherPatient
                    Definition

                    Father

                    ShortFather
                    Comments

                    If there are no entries in the list, an emptyReason SHOULD be provided.

                    Control0..1
                    This element is affected by the following invariants: cmp-2
                    TypeReference(Related Person - Parent Vital Records)
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    168. Composition.section:father.entry:inputRaceAndEthnicity
                    Slice NameinputRaceAndEthnicity
                    Definition

                    InputRaceAndEthnicity

                    ShortInput Race And Ethnicity
                    Comments

                    If there are no entries in the list, an emptyReason SHOULD be provided.

                    Control0..1
                    This element is affected by the following invariants: cmp-2
                    TypeReference(Observation - Input Race and Ethnicity Vital Records)
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    170. Composition.section:father.entry:codedRaceAndEthnicity
                    Slice NamecodedRaceAndEthnicity
                    Definition

                    Coded Race And Ethnicity

                    ShortCoded Race And Ethnicity
                    Comments

                    If there are no entries in the list, an emptyReason SHOULD be provided.

                    Control0..1
                    This element is affected by the following invariants: cmp-2
                    TypeReference(Observation - Coded Race and Ethnicity Vital Records)
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    172. Composition.section:father.emptyReason
                    Definition

                    If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                    ShortWhy the section is empty
                    Comments

                    The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                    Control0..1
                    This element is affected by the following invariants: cmp-2
                    BindingThe codes SHOULD be taken from ListEmptyReasons
                    (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                    If a section is empty, why it is empty.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Summaryfalse
                    Requirements

                    Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    174. Composition.section:father.section
                    Definition

                    A nested sub-section within this section.

                    ShortNested Section
                    Comments

                    Nested sections are primarily used to help human readers navigate to particular portions of the document.

                    Control0..*
                    This element is affected by the following invariants: cmp-1
                    TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))