Post-Acute FHIR Based Orders
0.1.0 - STU 1 Ballot

This page is part of the Post Acute Orders FHIR IG (v0.1.0: STU 1 Ballot 1) based on FHIR R4. . For a full list of available versions, see the Directory of published versions

StructureDefinition: PAOMessageDefinition4b - JSON Profile

JSON representation of the PAO-message-definition4b Profile.

{
  "resourceType" : "StructureDefinition",
  "id" : "PAO-message-definition4b",
  "meta" : {
    "versionId" : "11",
    "lastUpdated" : "2020-04-03T03:23:55.565+00:00",
    "source" : "#eDOylPl2cqjMcOTw"
  },
  "text" : {
    "status" : "additional",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">This will be resource text</div>"
  },
  "url" : "http://hl7.org/fhir/us/dme-orders/PAO-message-definition4b",
  "version" : "0.1.0",
  "name" : "PAOMessageDefinition4b",
  "title" : "PAO Message Defnintion 4b",
  "status" : "active",
  "date" : "2020-04-02T00:00:00+00:00",
  "publisher" : "HL7",
  "contact" : [
    {
      "name" : "HL7 International - Orders and Observations",
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/orders"
        }
      ]
    }
  ],
  "description" : "PAO MessageDefintion for use with the PAO MessageHeader for PAO orders",
  "fhirVersion" : "4.0.1",
  "mapping" : [
    {
      "identity" : "v2",
      "uri" : "http://hl7.org/v2",
      "name" : "HL7 v2 Mapping"
    },
    {
      "identity" : "rim",
      "uri" : "http://hl7.org/v3",
      "name" : "RIM Mapping"
    },
    {
      "identity" : "workflow",
      "uri" : "http://hl7.org/fhir/workflow",
      "name" : "Workflow Pattern"
    },
    {
      "identity" : "w5",
      "uri" : "http://hl7.org/fhir/fivews",
      "name" : "FiveWs Pattern Mapping"
    },
    {
      "identity" : "objimpl",
      "uri" : "http://hl7.org/fhir/object-implementation",
      "name" : "Object Implementation Information"
    }
  ],
  "kind" : "resource",
  "abstract" : false,
  "type" : "MessageDefinition",
  "baseDefinition" : "http://hl7.org/fhir/StructureDefinition/MessageDefinition",
  "derivation" : "constraint",
  "snapshot" : {
    "element" : [
      {
        "id" : "MessageDefinition",
        "path" : "MessageDefinition",
        "short" : "A resource that defines a type of message that can be exchanged between systems",
        "definition" : "Defines the characteristics of a message that can be shared between systems, including the type of event that initiates the message, the content to be transmitted and what response(s), if any, are permitted.",
        "comment" : "This would be a MIF-level artifact.",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "MessageDefinition",
          "min" : 0,
          "max" : "*"
        },
        "constraint" : [
          {
            "key" : "dom-2",
            "severity" : "error",
            "human" : "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
            "expression" : "contained.contained.empty()",
            "xpath" : "not(parent::f:contained and f:contained)",
            "source" : "http://hl7.org/fhir/StructureDefinition/DomainResource"
          },
          {
            "key" : "dom-3",
            "severity" : "error",
            "human" : "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",
            "expression" : "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()",
            "xpath" : "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
            "source" : "http://hl7.org/fhir/StructureDefinition/DomainResource"
          },
          {
            "key" : "dom-4",
            "severity" : "error",
            "human" : "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
            "expression" : "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
            "xpath" : "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
            "source" : "http://hl7.org/fhir/StructureDefinition/DomainResource"
          },
          {
            "key" : "dom-5",
            "severity" : "error",
            "human" : "If a resource is contained in another resource, it SHALL NOT have a security label",
            "expression" : "contained.meta.security.empty()",
            "xpath" : "not(exists(f:contained/*/f:meta/f:security))",
            "source" : "http://hl7.org/fhir/StructureDefinition/DomainResource"
          },
          {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
                "valueBoolean" : true
              },
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
                "valueMarkdown" : "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
              }
            ],
            "key" : "dom-6",
            "severity" : "warning",
            "human" : "A resource should have narrative for robust management",
            "expression" : "text.`div`.exists()",
            "xpath" : "exists(f:text/h:div)",
            "source" : "http://hl7.org/fhir/StructureDefinition/DomainResource"
          },
          {
            "key" : "msd-0",
            "severity" : "warning",
            "human" : "Name should be usable as an identifier for the module by machine processing applications such as code generation",
            "expression" : "name.matches('[A-Z]([A-Za-z0-9_]){0,254}')",
            "xpath" : "not(exists(f:name/@value)) or matches(f:name/@value, '[A-Z]([A-Za-z0-9_]){0,254}')",
            "source" : "http://hl7.org/fhir/StructureDefinition/MessageDefinition"
          }
        ],
        "isModifier" : false,
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "Entity. Role, or Act"
          },
          {
            "identity" : "v2",
            "map" : "N/A"
          },
          {
            "identity" : "rim",
            "map" : "N/A"
          }
        ]
      },
      {
        "id" : "MessageDefinition.id",
        "path" : "MessageDefinition.id",
        "short" : "Logical id of this artifact",
        "definition" : "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
        "comment" : "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Resource.id",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                "valueUrl" : "string"
              }
            ],
            "code" : "http://hl7.org/fhirpath/System.String"
          }
        ],
        "isModifier" : false,
        "isSummary" : true
      },
      {
        "id" : "MessageDefinition.meta",
        "path" : "MessageDefinition.meta",
        "short" : "Metadata about the resource",
        "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.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Resource.meta",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "Meta"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier" : false,
        "isSummary" : true
      },
      {
        "id" : "MessageDefinition.implicitRules",
        "path" : "MessageDefinition.implicitRules",
        "short" : "A set of rules under which this content was created",
        "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.",
        "comment" : "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.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Resource.implicitRules",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "uri"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier" : true,
        "isModifierReason" : "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",
        "isSummary" : true
      },
      {
        "id" : "MessageDefinition.language",
        "path" : "MessageDefinition.language",
        "short" : "Language of the resource content",
        "definition" : "The base language in which the resource is written.",
        "comment" : "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).",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Resource.language",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "code"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier" : false,
        "isSummary" : false,
        "binding" : {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
              "valueCanonical" : "http://hl7.org/fhir/ValueSet/all-languages"
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString" : "Language"
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
              "valueBoolean" : true
            }
          ],
          "strength" : "preferred",
          "description" : "A human language.",
          "valueSet" : "http://hl7.org/fhir/ValueSet/languages"
        }
      },
      {
        "id" : "MessageDefinition.text",
        "path" : "MessageDefinition.text",
        "short" : "Text summary of the resource, for human interpretation",
        "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.",
        "comment" : "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.",
        "alias" : [
          "narrative",
          "html",
          "xhtml",
          "display"
        ],
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "DomainResource.text",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "Narrative"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier" : false,
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "Act.text?"
          }
        ]
      },
      {
        "id" : "MessageDefinition.contained",
        "path" : "MessageDefinition.contained",
        "short" : "Contained, inline Resources",
        "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.",
        "comment" : "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.",
        "alias" : [
          "inline resources",
          "anonymous resources",
          "contained resources"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "DomainResource.contained",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Resource"
          }
        ],
        "isModifier" : false,
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "N/A"
          }
        ]
      },
      {
        "id" : "MessageDefinition.extension",
        "path" : "MessageDefinition.extension",
        "short" : "Additional content defined by implementations",
        "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.",
        "comment" : "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.",
        "alias" : [
          "extensions",
          "user content"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "DomainResource.extension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key" : "ext-1",
            "severity" : "error",
            "human" : "Must have either extensions or value[x], not both",
            "expression" : "extension.exists() != value.exists()",
            "xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
            "source" : "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "isModifier" : false,
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "N/A"
          }
        ]
      },
      {
        "id" : "MessageDefinition.modifierExtension",
        "path" : "MessageDefinition.modifierExtension",
        "short" : "Extensions that cannot be ignored",
        "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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
        "comment" : "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.",
        "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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
        "alias" : [
          "extensions",
          "user content"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "DomainResource.modifierExtension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key" : "ext-1",
            "severity" : "error",
            "human" : "Must have either extensions or value[x], not both",
            "expression" : "extension.exists() != value.exists()",
            "xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
            "source" : "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "isModifier" : true,
        "isModifierReason" : "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "N/A"
          }
        ]
      },
      {
        "id" : "MessageDefinition.url",
        "path" : "MessageDefinition.url",
        "short" : "Business Identifier for a given MessageDefinition",
        "definition" : "The business identifier that is used to reference the MessageDefinition and *is* expected to be consistent from server to server.",
        "comment" : "Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred.  Multiple instances may share the same URL if they have a distinct version.\n\nThe determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author.  Considerations for making this decision are found in [Technical and Business Versions](http://hl7.org/fhir/R4/resource.html#versions). \n\nIn some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the [meta.source](http://hl7.org/fhir/R4/resource.html#meta) element to indicate where the current master source of the resource can be found.",
        "requirements" : "Allows the message definition to be referenced by a single globally unique identifier.",
        "min" : 1,
        "max" : "1",
        "base" : {
          "path" : "MessageDefinition.url",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "uri"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport" : true,
        "isModifier" : false,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "workflow",
            "map" : "Definition.url"
          },
          {
            "identity" : "w5",
            "map" : "FiveWs.identifier"
          }
        ]
      },
      {
        "id" : "MessageDefinition.identifier",
        "path" : "MessageDefinition.identifier",
        "short" : "Primary key for the message definition on a given server",
        "definition" : "A formal identifier that is used to identify this message definition when it is represented in other formats, or referenced in a specification, model, design or an instance.",
        "comment" : "Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this message definition outside of FHIR, where it is not possible to use the logical URI.",
        "requirements" : "Allows externally provided and/or usable business identifiers to be easily associated with the module.",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "MessageDefinition.identifier",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Identifier"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier" : false,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "workflow",
            "map" : "Definition.identifier"
          },
          {
            "identity" : "w5",
            "map" : "FiveWs.identifier"
          },
          {
            "identity" : "objimpl",
            "map" : "no-gen-base"
          }
        ]
      },
      {
        "id" : "MessageDefinition.version",
        "path" : "MessageDefinition.version",
        "short" : "Business version of the message definition",
        "definition" : "The identifier that is used to identify this version of the message definition when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the message definition author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence.",
        "comment" : "There may be different message definition instances that have the same identifier but different versions.  The version can be appended to the url in a reference to allow a reference to a particular business version of the message definition with the format [url]|[version].",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "MessageDefinition.version",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "string"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport" : true,
        "isModifier" : false,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "workflow",
            "map" : "Definition.version"
          },
          {
            "identity" : "w5",
            "map" : "FiveWs.version"
          }
        ]
      },
      {
        "id" : "MessageDefinition.name",
        "path" : "MessageDefinition.name",
        "short" : "Name for this message definition (computer friendly)",
        "definition" : "A natural language name identifying the message definition. This name should be usable as an identifier for the module by machine processing applications such as code generation.",
        "comment" : "The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.",
        "requirements" : "Support human navigation and code generation.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "MessageDefinition.name",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "string"
          }
        ],
        "condition" : [
          "inv-0"
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport" : true,
        "isModifier" : false,
        "isSummary" : true
      },
      {
        "id" : "MessageDefinition.title",
        "path" : "MessageDefinition.title",
        "short" : "Name for this message definition (human friendly)",
        "definition" : "A short, descriptive, user-friendly title for the message definition.",
        "comment" : "This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "MessageDefinition.title",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "string"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport" : true,
        "isModifier" : false,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "workflow",
            "map" : "Definition.title"
          }
        ]
      },
      {
        "id" : "MessageDefinition.replaces",
        "path" : "MessageDefinition.replaces",
        "short" : "Takes the place of",
        "definition" : "A MessageDefinition that is superseded by this definition.",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "MessageDefinition.replaces",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "canonical",
            "targetProfile" : [
              "http://hl7.org/fhir/StructureDefinition/MessageDefinition"
            ]
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier" : false,
        "isSummary" : true
      },
      {
        "id" : "MessageDefinition.status",
        "path" : "MessageDefinition.status",
        "short" : "draft | active | retired | unknown",
        "definition" : "The status of this message definition. Enables tracking the life-cycle of the content.",
        "comment" : "Allows filtering of message definitions that are appropriate for use versus not.",
        "min" : 1,
        "max" : "1",
        "base" : {
          "path" : "MessageDefinition.status",
          "min" : 1,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "code"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport" : true,
        "isModifier" : true,
        "isModifierReason" : "This is labeled as \"Is Modifier\" because applications should not use a retired {{title}} without due consideration",
        "isSummary" : true,
        "binding" : {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString" : "PublicationStatus"
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
              "valueBoolean" : true
            }
          ],
          "strength" : "required",
          "description" : "The lifecycle status of an artifact.",
          "valueSet" : "http://hl7.org/fhir/ValueSet/publication-status|4.0.1"
        },
        "mapping" : [
          {
            "identity" : "workflow",
            "map" : "Definition.status"
          },
          {
            "identity" : "w5",
            "map" : "FiveWs.status"
          }
        ]
      },
      {
        "id" : "MessageDefinition.experimental",
        "path" : "MessageDefinition.experimental",
        "short" : "For testing purposes, not real usage",
        "definition" : "A Boolean value to indicate that this message definition is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage.",
        "comment" : "Allows filtering of message definitions that are appropriate for use versus not.",
        "requirements" : "Enables experimental content to be developed following the same lifecycle that would be used for a production-level message definition.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "MessageDefinition.experimental",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "boolean"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier" : false,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "workflow",
            "map" : "Definition.experimental"
          },
          {
            "identity" : "w5",
            "map" : "FiveWs.class"
          }
        ]
      },
      {
        "id" : "MessageDefinition.date",
        "path" : "MessageDefinition.date",
        "short" : "Date last changed",
        "definition" : "The date  (and optionally time) when the message definition was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the message definition changes.",
        "comment" : "Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the message definition. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.",
        "alias" : [
          "Revision Date"
        ],
        "min" : 1,
        "max" : "1",
        "base" : {
          "path" : "MessageDefinition.date",
          "min" : 1,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "dateTime"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport" : true,
        "isModifier" : false,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "workflow",
            "map" : "Definition.date"
          },
          {
            "identity" : "w5",
            "map" : "FiveWs.recorded"
          }
        ]
      },
      {
        "id" : "MessageDefinition.publisher",
        "path" : "MessageDefinition.publisher",
        "short" : "Name of the publisher (organization or individual)",
        "definition" : "The name of the organization or individual that published the message definition.",
        "comment" : "Usually an organization but may be an individual. The publisher (or steward) of the message definition is the organization or individual primarily responsible for the maintenance and upkeep of the message definition. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the message definition. This item SHOULD be populated unless the information is available from context.",
        "requirements" : "Helps establish the \"authority/credibility\" of the message definition.  May also allow for contact.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "MessageDefinition.publisher",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "string"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport" : true,
        "isModifier" : false,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "workflow",
            "map" : "Definition.publisher"
          },
          {
            "identity" : "w5",
            "map" : "FiveWs.witness"
          }
        ]
      },
      {
        "id" : "MessageDefinition.contact",
        "path" : "MessageDefinition.contact",
        "short" : "Contact details for the publisher",
        "definition" : "Contact details to assist a user in finding and communicating with the publisher.",
        "comment" : "May be a web site, an email address, a telephone number, etc.",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "MessageDefinition.contact",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "ContactDetail"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier" : false,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "workflow",
            "map" : "Definition.contact"
          }
        ]
      },
      {
        "id" : "MessageDefinition.description",
        "path" : "MessageDefinition.description",
        "short" : "Natural language description of the message definition",
        "definition" : "A free text natural language description of the message definition from a consumer's perspective.",
        "comment" : "This description can be used to capture details such as why the message definition was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the message definition as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the message definition is presumed to be the predominant language in the place the message definition was created).",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "MessageDefinition.description",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "markdown"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport" : true,
        "isModifier" : false,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "workflow",
            "map" : "Definition.description"
          }
        ]
      },
      {
        "id" : "MessageDefinition.useContext",
        "path" : "MessageDefinition.useContext",
        "short" : "The context that the content is intended to support",
        "definition" : "The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate message definition instances.",
        "comment" : "When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.",
        "requirements" : "Assist in searching for appropriate content.",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "MessageDefinition.useContext",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "UsageContext"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier" : false,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "workflow",
            "map" : "Definition.useContext"
          }
        ]
      },
      {
        "id" : "MessageDefinition.jurisdiction",
        "path" : "MessageDefinition.jurisdiction",
        "short" : "Intended jurisdiction for message definition (if applicable)",
        "definition" : "A legal or geographic region in which the message definition is intended to be used.",
        "comment" : "It may be possible for the message definition to be used in jurisdictions other than those for which it was originally designed or intended.",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "MessageDefinition.jurisdiction",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "CodeableConcept"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier" : false,
        "isSummary" : true,
        "binding" : {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString" : "Jurisdiction"
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
              "valueBoolean" : true
            }
          ],
          "strength" : "extensible",
          "description" : "Countries and regions within which this artifact is targeted for use.",
          "valueSet" : "http://hl7.org/fhir/ValueSet/jurisdiction"
        },
        "mapping" : [
          {
            "identity" : "workflow",
            "map" : "Definition.jurisdiction"
          }
        ]
      },
      {
        "id" : "MessageDefinition.purpose",
        "path" : "MessageDefinition.purpose",
        "short" : "Why this message definition is defined",
        "definition" : "Explanation of why this message definition is needed and why it has been designed as it has.",
        "comment" : "This element does not describe the usage of the message definition. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is.  This may be used to point to source materials or specifications that drove the structure of this message definition.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "MessageDefinition.purpose",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "markdown"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier" : false,
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "workflow",
            "map" : "Definition.purpose"
          },
          {
            "identity" : "w5",
            "map" : "FiveWs.why[x]"
          },
          {
            "identity" : "objimpl",
            "map" : "no-gen-base"
          }
        ]
      },
      {
        "id" : "MessageDefinition.copyright",
        "path" : "MessageDefinition.copyright",
        "short" : "Use and/or publishing restrictions",
        "definition" : "A copyright statement relating to the message definition and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the message definition.",
        "requirements" : "Consumers must be able to determine any legal restrictions on the use of the message definition and/or its content.",
        "alias" : [
          "License",
          "Restrictions"
        ],
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "MessageDefinition.copyright",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "markdown"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier" : false,
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "workflow",
            "map" : "Definition.copyright"
          },
          {
            "identity" : "objimpl",
            "map" : "no-gen-base"
          }
        ]
      },
      {
        "id" : "MessageDefinition.base",
        "path" : "MessageDefinition.base",
        "short" : "Definition this one is based on",
        "definition" : "The MessageDefinition that is the basis for the contents of this resource.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "MessageDefinition.base",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "canonical",
            "targetProfile" : [
              "http://hl7.org/fhir/StructureDefinition/MessageDefinition"
            ]
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier" : false,
        "isSummary" : true
      },
      {
        "id" : "MessageDefinition.parent",
        "path" : "MessageDefinition.parent",
        "short" : "Protocol/workflow this is part of",
        "definition" : "Identifies a protocol or workflow that this MessageDefinition represents a step in.",
        "comment" : "It should be possible to use MessageDefinition to describe a message to be used by certain steps in a particular protocol as part of a PlanDefinition or ActivityDefinition.",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "MessageDefinition.parent",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "canonical",
            "targetProfile" : [
              "http://hl7.org/fhir/StructureDefinition/ActivityDefinition",
              "http://hl7.org/fhir/StructureDefinition/PlanDefinition"
            ]
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier" : false,
        "isSummary" : true
      },
      {
        "id" : "MessageDefinition.event[x]",
        "path" : "MessageDefinition.event[x]",
        "short" : "Event code  or link to the EventDefinition",
        "definition" : "Event code or link to the EventDefinition.",
        "min" : 1,
        "max" : "1",
        "base" : {
          "path" : "MessageDefinition.event[x]",
          "min" : 1,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "Coding"
          },
          {
            "code" : "uri"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport" : true,
        "isModifier" : false,
        "isSummary" : true,
        "binding" : {
          "strength" : "required",
          "valueSet" : "http://hl7.org/fhir/us/dme-orders/ValueSet/PAO-Message-Event"
        }
      },
      {
        "id" : "MessageDefinition.category",
        "path" : "MessageDefinition.category",
        "short" : "consequence | currency | notification",
        "definition" : "The impact of the content of the message.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "MessageDefinition.category",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "code"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport" : true,
        "isModifier" : false,
        "isSummary" : true,
        "binding" : {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString" : "MessageSignificanceCategory"
            }
          ],
          "strength" : "required",
          "description" : "The impact of the content of a message.",
          "valueSet" : "http://hl7.org/fhir/ValueSet/message-significance-category|4.0.1"
        }
      },
      {
        "id" : "MessageDefinition.focus",
        "path" : "MessageDefinition.focus",
        "short" : "Resource(s) that are the subject of the event",
        "definition" : "Identifies the resource (or resources) that are being addressed by the event.  For example, the Encounter for an admit message or two Account records for a merge.",
        "min" : 1,
        "max" : "*",
        "base" : {
          "path" : "MessageDefinition.focus",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "BackboneElement"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key" : "md-1",
            "severity" : "error",
            "human" : "Max must be postive int or *",
            "expression" : "max='*' or (max.toInteger() > 0)",
            "xpath" : "f:max/@value='*' or number(f:max/@value) > 0",
            "source" : "http://hl7.org/fhir/StructureDefinition/MessageDefinition"
          }
        ],
        "mustSupport" : true,
        "isModifier" : false,
        "isSummary" : true
      },
      {
        "id" : "MessageDefinition.focus.id",
        "path" : "MessageDefinition.focus.id",
        "representation" : [
          "xmlAttr"
        ],
        "short" : "Unique id for inter-element referencing",
        "definition" : "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Element.id",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                "valueUrl" : "string"
              }
            ],
            "code" : "http://hl7.org/fhirpath/System.String"
          }
        ],
        "isModifier" : false,
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "MessageDefinition.focus.extension",
        "path" : "MessageDefinition.focus.extension",
        "short" : "Additional content defined by implementations",
        "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.",
        "comment" : "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.",
        "alias" : [
          "extensions",
          "user content"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Element.extension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key" : "ext-1",
            "severity" : "error",
            "human" : "Must have either extensions or value[x], not both",
            "expression" : "extension.exists() != value.exists()",
            "xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
            "source" : "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "isModifier" : false,
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "MessageDefinition.focus.modifierExtension",
        "path" : "MessageDefinition.focus.modifierExtension",
        "short" : "Extensions that cannot be ignored even if unrecognized",
        "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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
        "comment" : "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.",
        "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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
        "alias" : [
          "extensions",
          "user content",
          "modifiers"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "BackboneElement.modifierExtension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key" : "ext-1",
            "severity" : "error",
            "human" : "Must have either extensions or value[x], not both",
            "expression" : "extension.exists() != value.exists()",
            "xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
            "source" : "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "isModifier" : true,
        "isModifierReason" : "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "N/A"
          }
        ]
      },
      {
        "id" : "MessageDefinition.focus.code",
        "path" : "MessageDefinition.focus.code",
        "short" : "Type of resource",
        "definition" : "The kind of resource that must be the focus for this message.",
        "comment" : "Multiple focuses addressing different resources may occasionally occur.  E.g. to link or unlink a resource from a particular account or encounter, etc.",
        "min" : 1,
        "max" : "1",
        "base" : {
          "path" : "MessageDefinition.focus.code",
          "min" : 1,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "code"
          }
        ],
        "fixedCode" : "Task",
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport" : true,
        "isModifier" : false,
        "isSummary" : true,
        "binding" : {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString" : "ResourceType"
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
              "valueBoolean" : true
            }
          ],
          "strength" : "required",
          "description" : "One of the resource types defined as part of this version of FHIR.",
          "valueSet" : "http://hl7.org/fhir/ValueSet/resource-types|4.0.1"
        }
      },
      {
        "id" : "MessageDefinition.focus.profile",
        "path" : "MessageDefinition.focus.profile",
        "short" : "Profile that must be adhered to by focus",
        "definition" : "A profile that reflects constraints for the focal resource (and potentially for related resources).",
        "comment" : "This should be present for most message definitions.  However, if the message focus is only a single resource and there is no need to include referenced resources or otherwise enforce the presence of particular elements, it can be omitted.",
        "requirements" : "This profile allows setting boundaries for what content must appear within the message bundle vs. outside based on the declared aggregation constraints on referenced resources on this and related profiles.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "MessageDefinition.focus.profile",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "canonical",
            "targetProfile" : [
              "http://hl7.org/fhir/StructureDefinition/StructureDefinition"
            ]
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier" : false,
        "isSummary" : false
      },
      {
        "id" : "MessageDefinition.focus.min",
        "path" : "MessageDefinition.focus.min",
        "short" : "Minimum number of focuses of this type",
        "definition" : "Identifies the minimum number of resources of this type that must be pointed to by a message in order for it to be valid against this MessageDefinition.",
        "min" : 1,
        "max" : "1",
        "base" : {
          "path" : "MessageDefinition.focus.min",
          "min" : 1,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "unsignedInt"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier" : false,
        "isSummary" : true
      },
      {
        "id" : "MessageDefinition.focus.max",
        "path" : "MessageDefinition.focus.max",
        "short" : "Maximum number of focuses of this type",
        "definition" : "Identifies the maximum number of resources of this type that must be pointed to by a message in order for it to be valid against this MessageDefinition.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "MessageDefinition.focus.max",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "string"
          }
        ],
        "condition" : [
          "md-1"
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier" : false,
        "isSummary" : false
      },
      {
        "id" : "MessageDefinition.responseRequired",
        "path" : "MessageDefinition.responseRequired",
        "short" : "always | on-error | never | on-success",
        "definition" : "Declare at a message definition level whether a response is required or only upon error or success, or never.",
        "comment" : "This enables the capability currently available through MSH-16 (Application Level acknowledgement) in HL7 Version 2 to declare at a message instance level whether a response is required or only upon error or success, or never.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "MessageDefinition.responseRequired",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "code"
          }
        ],
        "example" : [
          {
            "label" : "General",
            "valueCode" : "always"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier" : false,
        "isSummary" : false,
        "binding" : {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString" : "messageheader-response-request"
            }
          ],
          "strength" : "required",
          "description" : "HL7-defined table of codes which identify conditions under which acknowledgments are required to be returned in response to a message.",
          "valueSet" : "http://hl7.org/fhir/ValueSet/messageheader-response-request|4.0.1"
        },
        "mapping" : [
          {
            "identity" : "v2",
            "map" : "MSH-16"
          }
        ]
      },
      {
        "id" : "MessageDefinition.allowedResponse",
        "path" : "MessageDefinition.allowedResponse",
        "short" : "Responses to this message",
        "definition" : "Indicates what types of messages may be sent as an application-level response to this message.",
        "comment" : "This indicates an application level response to \"close\" a transaction implicit in a particular request message.  To define a complete workflow scenario, look to the [[PlanDefinition]] resource which allows the definition of complex orchestrations, conditionality, etc.",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "MessageDefinition.allowedResponse",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "BackboneElement"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier" : false,
        "isSummary" : false
      },
      {
        "id" : "MessageDefinition.allowedResponse.id",
        "path" : "MessageDefinition.allowedResponse.id",
        "representation" : [
          "xmlAttr"
        ],
        "short" : "Unique id for inter-element referencing",
        "definition" : "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Element.id",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                "valueUrl" : "string"
              }
            ],
            "code" : "http://hl7.org/fhirpath/System.String"
          }
        ],
        "isModifier" : false,
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "MessageDefinition.allowedResponse.extension",
        "path" : "MessageDefinition.allowedResponse.extension",
        "short" : "Additional content defined by implementations",
        "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.",
        "comment" : "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.",
        "alias" : [
          "extensions",
          "user content"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Element.extension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key" : "ext-1",
            "severity" : "error",
            "human" : "Must have either extensions or value[x], not both",
            "expression" : "extension.exists() != value.exists()",
            "xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
            "source" : "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "isModifier" : false,
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "MessageDefinition.allowedResponse.modifierExtension",
        "path" : "MessageDefinition.allowedResponse.modifierExtension",
        "short" : "Extensions that cannot be ignored even if unrecognized",
        "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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
        "comment" : "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.",
        "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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).",
        "alias" : [
          "extensions",
          "user content",
          "modifiers"
        ],
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "BackboneElement.modifierExtension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key" : "ext-1",
            "severity" : "error",
            "human" : "Must have either extensions or value[x], not both",
            "expression" : "extension.exists() != value.exists()",
            "xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
            "source" : "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "isModifier" : true,
        "isModifierReason" : "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
        "isSummary" : true,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "N/A"
          }
        ]
      },
      {
        "id" : "MessageDefinition.allowedResponse.message",
        "path" : "MessageDefinition.allowedResponse.message",
        "short" : "Reference to allowed message definition response",
        "definition" : "A reference to the message definition that must be adhered to by this supported response.",
        "min" : 1,
        "max" : "1",
        "base" : {
          "path" : "MessageDefinition.allowedResponse.message",
          "min" : 1,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "canonical",
            "targetProfile" : [
              "http://hl7.org/fhir/StructureDefinition/MessageDefinition"
            ]
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier" : false,
        "isSummary" : false
      },
      {
        "id" : "MessageDefinition.allowedResponse.situation",
        "path" : "MessageDefinition.allowedResponse.situation",
        "short" : "When should this response be used",
        "definition" : "Provides a description of the circumstances in which this response should be used (as opposed to one of the alternative responses).",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "MessageDefinition.allowedResponse.situation",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "markdown"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier" : false,
        "isSummary" : false
      },
      {
        "id" : "MessageDefinition.graph",
        "path" : "MessageDefinition.graph",
        "short" : "Canonical reference to a GraphDefinition",
        "definition" : "Canonical reference to a GraphDefinition. If a URL is provided, it is the canonical reference to a [GraphDefinition](http://hl7.org/fhir/R4/graphdefinition.html) that it controls what resources are to be added to the bundle when building the document. The GraphDefinition can also specify profiles that apply to the various resources.",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "MessageDefinition.graph",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "canonical",
            "targetProfile" : [
              "http://hl7.org/fhir/StructureDefinition/GraphDefinition"
            ]
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier" : false,
        "isSummary" : false
      }
    ]
  },
  "differential" : {
    "element" : [
      {
        "id" : "MessageDefinition",
        "path" : "MessageDefinition"
      },
      {
        "id" : "MessageDefinition.url",
        "path" : "MessageDefinition.url",
        "min" : 1,
        "mustSupport" : true
      },
      {
        "id" : "MessageDefinition.version",
        "path" : "MessageDefinition.version",
        "mustSupport" : true
      },
      {
        "id" : "MessageDefinition.name",
        "path" : "MessageDefinition.name",
        "mustSupport" : true
      },
      {
        "id" : "MessageDefinition.title",
        "path" : "MessageDefinition.title",
        "mustSupport" : true
      },
      {
        "id" : "MessageDefinition.status",
        "path" : "MessageDefinition.status",
        "mustSupport" : true
      },
      {
        "id" : "MessageDefinition.date",
        "path" : "MessageDefinition.date",
        "mustSupport" : true
      },
      {
        "id" : "MessageDefinition.publisher",
        "path" : "MessageDefinition.publisher",
        "mustSupport" : true
      },
      {
        "id" : "MessageDefinition.description",
        "path" : "MessageDefinition.description",
        "mustSupport" : true
      },
      {
        "id" : "MessageDefinition.event[x]",
        "path" : "MessageDefinition.event[x]",
        "mustSupport" : true,
        "binding" : {
          "strength" : "required",
          "valueSet" : "http://hl7.org/fhir/us/dme-orders/ValueSet/PAO-Message-Event"
        }
      },
      {
        "id" : "MessageDefinition.category",
        "path" : "MessageDefinition.category",
        "mustSupport" : true
      },
      {
        "id" : "MessageDefinition.focus",
        "path" : "MessageDefinition.focus",
        "min" : 1,
        "mustSupport" : true
      },
      {
        "id" : "MessageDefinition.focus.code",
        "path" : "MessageDefinition.focus.code",
        "fixedCode" : "Task",
        "mustSupport" : true
      }
    ]
  }
}