HL7 Europe Imaging Study Report
0.1.0-ballot - ci-build 150

HL7 Europe Imaging Study Report, published by HL7 Europe. This guide is not an authorized publication; it is the continuous build for version 0.1.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/oijauregui/ehdsimaging/tree/master and changes regularly. See the Directory of published versions

Resource Profile: ImComposition - Detailed Descriptions

Page standards status: Draft Maturity Level: 1

Definitions for the ImComposition resource profile.

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

0. Composition
Definition

Imaging Study Report composition.

A composition is a set of healthcare-related information that is assembled together into a single logical document 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.

While a Composition defines the structure, it does not actually contain the content: rather the full content of a document is contained in a Bundle, of which the Composition is the first resource contained.

The text field of each section SHALL contain a textual representation of all listed entries.


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.).

ShortImaging Report compositionA 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.extension
Definition

An Extension


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

ShortExtensionAdditional content defined by implementations
Comments

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

Control10..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Composition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. Composition.extension:versionNumber
    Slice NameversionNumber
    Definition

    Version specific identifier for the composition, assigned when each version is created/updated.

    ShortVersion-specific identifier for composition
    Comments

    While each resource, including the composition itself, has its own version identifier, this is a formal identifier for the logical version of the composition as a whole. It would remain constant if the resources were moved to a new server, and all got new individual resource versions, for example.

    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(Composition Version Number) (Extension Type: string)
    Is Modifierfalse
    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())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    8. Composition.extension:basedOn
    Slice NamebasedOn
    Definition

    A plan, proposal or order that is fulfilled in whole or in part by this event.

    ShortFulfills plan, proposal or order
    Control0..*
    TypeExtension(Based on) (Extension Type: Reference(Resource))
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    10. Composition.extension:informationRecipient
    Slice NameinformationRecipient
    Definition

    This extension applies to the Composition resource and is used to represent an intended recipient of the composition.

    ShortComposition: Information recipient
    Control0..*
    TypeExtension(Composition: Information recipient) (Extension Type: Reference(Practitioner, Device, Patient, RelatedPerson, PractitionerRole, Organization))
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    12. Composition.extension:diagnosticreport-reference
    Slice Namediagnosticreport-reference
    Definition

    This extension provides a reference to the DiagnosticReport instance that is associated with this Composition.

    ShortDocument DiagnosticReport Reference
    Control1..1
    TypeExtension(Document DiagnosticReport Reference) (Extension Type: Reference(Imaging Diagnostic Report))
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    14. 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.


    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())
    16. 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()))
    18. Composition.type
    Definition

    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.

    ShortKind 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
    BindingUnless not suitable, these codes SHALL be taken from The codes SHOULD be taken from HL7 EU Imaging Report Typeshttp://hl7.org/fhir/ValueSet/doc-typecodes
    (extensible to http://hl7.eu/fhir/imaging-r4/ValueSet/ImImagingReportTypesEuVS)
    TypeCodeableConcept
    Is Modifierfalse
    Summarytrue
    Requirements

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

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

    A reference to a code defined by a terminology system.

    ShortCode defined by a terminology system
    Comments

    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

    Control10..*
    TypeCoding
    Is Modifierfalse
    Summarytrue
    Requirements

    Allows for alternative encodings within a code system, and translations to other code systems.

    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.type.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ $this
    • 22. Composition.type.coding:eu-template
      Slice Nameeu-template
      Definition

      A reference to a code defined by a terminology system.

      ShortCode defined by a terminology system
      Comments

      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

      Control10..1*
      TypeCoding
      Is Modifierfalse
      Summarytrue
      Requirements

      Allows for alternative encodings within a code system, and translations to other code systems.

      Pattern Value{
        "system" : "http://hl7.eu/fhir/imaging-r4/CodeSystem/Hl7EuDocumentTypes",
        "code" : "imaging-report-v0-0-1",
        "display" : "Imaging Report V0.0.1"
      }
      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.

      Control10..*
      BindingFor example codes, see DocumentClassValueSethttp://hl7.org/fhir/ValueSet/document-classcodes
      (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()))
      SlicingThis element introduces a set of slices on Composition.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ $this
      • 26. Composition.category:imaging
        Slice Nameimaging
        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.

        Control10..1*
        BindingFor example codes, see DocumentClassValueSethttp://hl7.org/fhir/ValueSet/document-classcodes
        (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.

        Pattern Value{
          "coding" : [{
            "system" : "http://loinc.org",
            "code" : "18748-4",
            "display" : "Diagnostic imaging study"
          }]
        }
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. Composition.category:imaging.coding
        Definition

        A reference to a code defined by a terminology system.

        ShortCode defined by a terminology system
        Comments

        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

        Control10..1*
        TypeCoding
        Is Modifierfalse
        Summarytrue
        Requirements

        Allows for alternative encodings within a code system, and translations to other code systems.

        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.


        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

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

        ShortWho and/or what authored the composition
        Control1..*
        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()))
        SlicingThis element introduces a set of slices on Composition.author. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • profile @ $this
        • 34. Composition.author:author
          Slice Nameauthor
          Definition

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

          ShortWho and/or what authored the composition
          Control01..*
          TypeReference(PractitionerRole (EU base), 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()))
          36. Composition.author:authoringDevice
          Slice NameauthoringDevice
          Definition

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

          ShortWho and/or what authored the composition
          Control01..*
          TypeReference(Device, Practitioner, PractitionerRole, 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()))
          38. 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()))
          40. 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()))
          SlicingThis element introduces a set of slices on Composition.attester. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ mode
          • 42. 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.


            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())
            44. Composition.attester.mode
            Definition

            The type of attestation the authenticator offers.

            Shortpersonal | professional | legal | official
            Control1..1
            BindingThe codes SHALL be taken from CompositionAttestationModehttp://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1
            (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()))
            46. Composition.attester:legalAuthenticator
            Slice NamelegalAuthenticator
            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()))
            48. Composition.attester:legalAuthenticator.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.


            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())
            50. Composition.attester:legalAuthenticator.mode
            Definition

            The type of attestation the authenticator offers.

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

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

            When the composition was attested by the party.

            ShortWhen the composition was attested
            Control10..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()))
            54. Composition.attester:legalAuthenticator.party
            Definition

            Who attested the composition in the specified way.

            ShortWho attested the composition
            Control0..1
            TypeReference(PractitionerRole (EU base), 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()))
            56. Composition.attester:resultValidator
            Slice NameresultValidator
            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()))
            58. Composition.attester:resultValidator.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.


            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())
            60. Composition.attester:resultValidator.mode
            Definition

            The type of attestation the authenticator offers.

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

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

            When the composition was attested by the party.

            ShortWhen the composition was attested
            Control10..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()))
            64. Composition.attester:resultValidator.party
            Definition

            Who attested the composition in the specified way.

            ShortWho attested the composition
            Control0..1
            TypeReference(PractitionerRole (EU base), 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()))
            66. Composition.custodian
            Definition

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

            ShortOrganization that manages the Imaging ReportOrganization 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 (EU base), 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()))
            68. 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.

            Control20..*
            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()))
            SlicingThis element introduces a set of slices on Composition.event. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ detail.concept
            • 70. 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.


              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())
              72. Composition.event:imagingstudy
              Slice Nameimagingstudy
              Definition

              The type of imaging modality used to perform the study.


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

              ShortModalityThe clinical service(s) being documented
              Comments

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

              Control10..*
              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()))
              74. Composition.event:imagingstudy.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.


              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())
              76. Composition.event:imagingstudy.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
              Control10..*
              TypeReference(Resource)
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              78. Composition.event:imagingstudy.detail.extension:detailext
              Slice Namedetailext
              Definition

              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 case the procedure being documented is necessarily a "History and Physical" act. The events may be included as a code or as a reference to an other resource.

              ShortThe event(s) being documented, as code(s), reference(s), or both
              Comments

              Composition.event.detail maps to R4 Composition.event.detail. So is mapped as Equivalent.

              Control0..*
              TypeExtension(Cross-version Extension for R5.Composition.event.detail for use in FHIR R4) (Extension Type: Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta)
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              80. Composition.event:imagingstudy.detail.extension:detailext.extension:_datatype
              Slice Name_datatype
              Definition

              Data type name for Composition.event.detail from FHIR R5

              ShortData type name for Composition.event.detail from FHIR R5
              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..1
              TypeExtension(Datatype) (Extension Type: string)
              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())
              ele-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())
              82. Composition.event:imagingstudy.detail.extension:detailext.extension:_datatype.url
              Definition

              Source of the definition for the extension code - a logical name or a URL.

              Shortidentifies the meaning of the extension
              Comments

              The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

              Control1..1
              Typeuri
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              Fixed Valuehttp://hl7.org/fhir/StructureDefinition/_datatype
              84. Composition.event:imagingstudy.detail.extension:detailext.extension:_datatype.value[x]
              Definition

              Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

              ShortValue of extension
              Comments

              Must be: CodeableReference

              Control10..1
              Typestring, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summaryfalse
              Fixed ValueCodeableReference
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              86. Composition.event:imagingstudy.detail.extension:detailext.extension:concept
              Slice Nameconcept
              Definition

              An Extension

              ShortExtensionAdditional content defined by implementations
              Control0..1*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              ele-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.event:imagingstudy.detail.extension:detailext.extension:concept.extension
              Definition

              An Extension


              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.

              ShortExtensionAdditional content defined by implementations
              Comments

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

              Control0..0*
              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())
              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on Composition.event.detail.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 90. Composition.event:imagingstudy.detail.extension:detailext.extension:concept.url
                Definition

                Source of the definition for the extension code - a logical name or a URL.

                Shortidentifies the meaning of the extension
                Comments

                The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                Control1..1
                Typeuri
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                Fixed Valueconcept
                92. Composition.event:imagingstudy.detail.extension:detailext.extension:concept.value[x]
                Definition

                A reference to a concept - e.g. the information is identified by its general class to the degree of precision found in the terminology.


                Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                ShortReference to a concept (by class)Value of extension
                Comments

                Composition.event.detail maps to R4 Composition.event.detail. So is mapped as Equivalent.

                Control0..1
                BindingUnless not suitable, these codes SHALL be taken from For codes, see https://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_33.html
                (extensible to https://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_33.html)
                TypeCodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                [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()))
                ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                94. Composition.event:imagingstudy.detail.extension:detailext.extension:reference
                Slice Namereference
                Definition

                An Extension

                ShortExtensionAdditional content defined by implementations
                Control0..1*
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                ele-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())
                96. Composition.event:imagingstudy.detail.extension:detailext.extension:reference.extension
                Definition

                An Extension


                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.

                ShortExtensionAdditional content defined by implementations
                Comments

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

                Control0..0*
                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())
                ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis element introduces a set of slices on Composition.event.detail.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 98. Composition.event:imagingstudy.detail.extension:detailext.extension:reference.url
                  Definition

                  Source of the definition for the extension code - a logical name or a URL.

                  Shortidentifies the meaning of the extension
                  Comments

                  The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                  Control1..1
                  Typeuri
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  Fixed Valuereference
                  100. Composition.event:imagingstudy.detail.extension:detailext.extension:reference.value[x]
                  Definition

                  A reference to a resource the provides exact details about the information being referenced.


                  Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                  ShortReference to a resource (by instance)Value of extension
                  Comments

                  Composition.event.detail maps to R4 Composition.event.detail. So is mapped as Equivalent.

                  Control0..1
                  TypeReference(IM Imaging Study), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                  [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()))
                  ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  102. Composition.event:imagingstudy.detail.extension:detailext.url
                  Definition

                  Source of the definition for the extension code - a logical name or a URL.

                  Shortidentifies the meaning of the extension
                  Comments

                  The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                  Control1..1
                  Typeuri
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  Fixed Valuehttp://hl7.org/fhir/5.0/StructureDefinition/extension-Composition.event.detail
                  104. Composition.event:imagingstudy.detail.extension:detailext.value[x]
                  Definition

                  Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                  ShortValue of extension
                  Control0..01
                  TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                  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()))
                  ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  106. Composition.event:procedure
                  Slice Nameprocedure
                  Definition

                  The type of imaging study performed.


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

                  ShortStudy TypeThe clinical service(s) being documented
                  Comments

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

                  Control10..*
                  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()))
                  108. Composition.event:procedure.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.


                  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())
                  110. Composition.event:procedure.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
                  Control10..*
                  TypeReference(Resource)
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  112. Composition.event:procedure.detail.extension:detailext
                  Slice Namedetailext
                  Definition

                  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 case the procedure being documented is necessarily a "History and Physical" act. The events may be included as a code or as a reference to an other resource.

                  ShortThe event(s) being documented, as code(s), reference(s), or both
                  Comments

                  Composition.event.detail maps to R4 Composition.event.detail. So is mapped as Equivalent.

                  Control0..*
                  TypeExtension(Cross-version Extension for R5.Composition.event.detail for use in FHIR R4) (Extension Type: Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta)
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  114. Composition.event:procedure.detail.extension:detailext.extension:_datatype
                  Slice Name_datatype
                  Definition

                  Data type name for Composition.event.detail from FHIR R5

                  ShortData type name for Composition.event.detail from FHIR R5
                  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..1
                  TypeExtension(Datatype) (Extension Type: string)
                  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())
                  ele-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.event:procedure.detail.extension:detailext.extension:_datatype.url
                  Definition

                  Source of the definition for the extension code - a logical name or a URL.

                  Shortidentifies the meaning of the extension
                  Comments

                  The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                  Control1..1
                  Typeuri
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  Fixed Valuehttp://hl7.org/fhir/StructureDefinition/_datatype
                  118. Composition.event:procedure.detail.extension:detailext.extension:_datatype.value[x]
                  Definition

                  Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                  ShortValue of extension
                  Comments

                  Must be: CodeableReference

                  Control10..1
                  Typestring, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Fixed ValueCodeableReference
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  120. Composition.event:procedure.detail.extension:detailext.extension:concept
                  Slice Nameconcept
                  Definition

                  An Extension

                  ShortExtensionAdditional content defined by implementations
                  Control0..1*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  ele-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())
                  122. Composition.event:procedure.detail.extension:detailext.extension:concept.extension
                  Definition

                  An Extension


                  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.

                  ShortExtensionAdditional content defined by implementations
                  Comments

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

                  Control0..0*
                  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())
                  ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  SlicingThis element introduces a set of slices on Composition.event.detail.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 124. Composition.event:procedure.detail.extension:detailext.extension:concept.url
                    Definition

                    Source of the definition for the extension code - a logical name or a URL.

                    Shortidentifies the meaning of the extension
                    Comments

                    The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                    Control1..1
                    Typeuri
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    Fixed Valueconcept
                    126. Composition.event:procedure.detail.extension:detailext.extension:concept.value[x]
                    Definition

                    A reference to a concept - e.g. the information is identified by its general class to the degree of precision found in the terminology.


                    Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                    ShortReference to a concept (by class)Value of extension
                    Comments

                    Composition.event.detail maps to R4 Composition.event.detail. So is mapped as Equivalent.

                    Control0..1
                    BindingUnless not suitable, these codes SHALL be taken from For codes, see https://www.hl7.org/fhir/valueset-procedure-reason.html
                    (extensible to https://www.hl7.org/fhir/valueset-procedure-reason.html)
                    TypeCodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                    [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()))
                    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    128. Composition.event:procedure.detail.extension:detailext.extension:reference
                    Slice Namereference
                    Definition

                    An Extension

                    ShortExtensionAdditional content defined by implementations
                    Control0..1*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    ele-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())
                    130. Composition.event:procedure.detail.extension:detailext.extension:reference.extension
                    Definition

                    An Extension


                    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.

                    ShortExtensionAdditional content defined by implementations
                    Comments

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

                    Control0..0*
                    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())
                    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    SlicingThis element introduces a set of slices on Composition.event.detail.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 132. Composition.event:procedure.detail.extension:detailext.extension:reference.url
                      Definition

                      Source of the definition for the extension code - a logical name or a URL.

                      Shortidentifies the meaning of the extension
                      Comments

                      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                      Control1..1
                      Typeuri
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      Fixed Valuereference
                      134. Composition.event:procedure.detail.extension:detailext.extension:reference.value[x]
                      Definition

                      A reference to a resource the provides exact details about the information being referenced.


                      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                      ShortReference to a resource (by instance)Value of extension
                      Comments

                      Composition.event.detail maps to R4 Composition.event.detail. So is mapped as Equivalent.

                      Control0..1
                      TypeReference(IM Imaging Procedure), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                      [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()))
                      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      136. Composition.event:procedure.detail.extension:detailext.url
                      Definition

                      Source of the definition for the extension code - a logical name or a URL.

                      Shortidentifies the meaning of the extension
                      Comments

                      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                      Control1..1
                      Typeuri
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      Fixed Valuehttp://hl7.org/fhir/5.0/StructureDefinition/extension-Composition.event.detail
                      138. Composition.event:procedure.detail.extension:detailext.value[x]
                      Definition

                      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                      ShortValue of extension
                      Control0..01
                      TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                      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()))
                      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      140. Composition.section
                      Definition

                      The root of the sections that make up the composition.

                      ShortComposition is broken into sections
                      Control80..*
                      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()))
                      eu-imaging-composition-1: When a section is empty, the emptyReason extension SHALL be present. (entry.empty() and emptyReason.exists())
                      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:
                      • value @ code
                      • 142. 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.


                        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())
                        144. 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.

                        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.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        146. 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 Reasons a section in an imaging report is empty.http://hl7.org/fhir/ValueSet/list-empty-reason
                        (preferred to http://hl7.eu/fhir/imaging-r4/ValueSet/ImSectionEmptyReason)
                        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()))
                        148. Composition.section:imagingstudy
                        Slice Nameimagingstudy
                        Definition

                        This section holds information related to the imaging studies covered by this report.


                        The root of the sections that make up the composition.

                        ShortImaging StudyComposition is broken into sections
                        Control10..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())
                        150. Composition.section:imagingstudy.extension
                        Definition

                        An Extension


                        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.

                        ShortExtensionAdditional content defined by implementations
                        Comments

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

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

                          Additional notes that apply to this resource or element.

                          ShortAdditional notes that apply to this resource or element.
                          Comments

                          This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                          Control0..*
                          TypeExtension(Note) (Extension Type: Annotation)
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          ele-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())
                          154. Composition.section:imagingstudy.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.


                          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())
                          156. Composition.section:imagingstudy.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://loinc.org",
                              "code" : "18726-0"
                            }]
                          }
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          158. Composition.section:imagingstudy.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.

                          Control10..*
                          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
                          • 160. Composition.section:imagingstudy.entry:imagingstudy
                            Slice Nameimagingstudy
                            Definition

                            This entry holds a reference to the Imaging Study instance that is associated with this Composition.


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

                            ShortImaging Study ReferenceA reference to data that supports this section
                            Comments

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

                            Control10..*
                            This element is affected by the following invariants: cmp-2
                            TypeReference(IM Imaging Study, Resource)
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            162. Composition.section:order
                            Slice Nameorder
                            Definition

                            This section holds information related to the order for the imaging study.


                            The root of the sections that make up the composition.

                            ShortOrderComposition is broken into sections
                            Control10..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())
                            164. Composition.section:order.extension
                            Definition

                            An Extension


                            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.

                            ShortExtensionAdditional content defined by implementations
                            Comments

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

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

                              Additional notes that apply to this resource or element.

                              ShortAdditional notes that apply to this resource or element.
                              Comments

                              This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                              Control0..*
                              TypeExtension(Note) (Extension Type: Annotation)
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              ele-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())
                              168. Composition.section:order.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.


                              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())
                              170. Composition.section:order.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://loinc.org",
                                  "code" : "55115-0",
                                  "display" : "Requested imaging studies information Document"
                                }]
                              }
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              172. Composition.section:order.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()))
                              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
                              • 174. Composition.section:order.entry:order
                                Slice Nameorder
                                Definition

                                This entry holds a reference to the order for the Imaging Study and report.


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

                                ShortOrder referenceA 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(IM Imaging Order, Resource)
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                176. Composition.section:history
                                Slice Namehistory
                                Definition

                                The root of the sections that make up the composition.

                                ShortHistoryComposition is broken into sections
                                Control10..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())
                                178. Composition.section:history.extension
                                Definition

                                An Extension


                                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.

                                ShortExtensionAdditional content defined by implementations
                                Comments

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

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

                                  Additional notes that apply to this resource or element.

                                  ShortAdditional notes that apply to this resource or element.
                                  Comments

                                  This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                  Control0..*
                                  TypeExtension(Note) (Extension Type: Annotation)
                                  Is Modifierfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  ele-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())
                                  182. Composition.section:history.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.


                                  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())
                                  184. Composition.section:history.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://loinc.org",
                                      "code" : "11329-0",
                                      "display" : "History general Narrative - Reported"
                                    }]
                                  }
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  186. Composition.section:procedure
                                  Slice Nameprocedure
                                  Definition

                                  The root of the sections that make up the composition.

                                  ShortProcedureComposition is broken into sections
                                  Control10..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())
                                  188. Composition.section:procedure.extension
                                  Definition

                                  An Extension


                                  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.

                                  ShortExtensionAdditional content defined by implementations
                                  Comments

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

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

                                    Additional notes that apply to this resource or element.

                                    ShortAdditional notes that apply to this resource or element.
                                    Comments

                                    This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                    Control0..*
                                    TypeExtension(Note) (Extension Type: Annotation)
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    ele-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())
                                    192. Composition.section:procedure.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.


                                    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())
                                    194. Composition.section:procedure.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://loinc.org",
                                        "code" : "55111-9",
                                        "display" : "Current imaging procedure descriptions Document"
                                      }]
                                    }
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    196. Composition.section:procedure.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()))
                                    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
                                    • 198. Composition.section:procedure.entry:procedure
                                      Slice Nameprocedure
                                      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(IM Imaging Procedure, Resource)
                                      Is Modifierfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      200. Composition.section:comparison
                                      Slice Namecomparison
                                      Definition

                                      The root of the sections that make up the composition.

                                      ShortHistoryComposition is broken into sections
                                      Control10..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())
                                      202. Composition.section:comparison.extension
                                      Definition

                                      An Extension


                                      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.

                                      ShortExtensionAdditional content defined by implementations
                                      Comments

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

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

                                        Additional notes that apply to this resource or element.

                                        ShortAdditional notes that apply to this resource or element.
                                        Comments

                                        This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                        Control0..*
                                        TypeExtension(Note) (Extension Type: Annotation)
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        ele-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())
                                        206. Composition.section:comparison.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.


                                        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())
                                        208. Composition.section:comparison.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://loinc.org",
                                            "code" : "18834-2",
                                            "display" : "Radiology Comparison study (narrative)"
                                          }]
                                        }
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        210. Composition.section:comparison.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()))
                                        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
                                        • 212. Composition.section:comparison.entry:comparedstudy
                                          Slice Namecomparedstudy
                                          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(IM Imaging Study, Imaging Selection profile for R4, Resource)
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          214. Composition.section:findings
                                          Slice Namefindings
                                          Definition

                                          The root of the sections that make up the composition.

                                          ShortFindingsComposition is broken into sections
                                          Control10..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())
                                          216. Composition.section:findings.extension
                                          Definition

                                          An Extension


                                          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.

                                          ShortExtensionAdditional content defined by implementations
                                          Comments

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

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

                                            Additional notes that apply to this resource or element.

                                            ShortAdditional notes that apply to this resource or element.
                                            Comments

                                            This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                            Control0..*
                                            TypeExtension(Note) (Extension Type: Annotation)
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            ele-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())
                                            220. Composition.section:findings.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.


                                            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())
                                            222. Composition.section:findings.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://loinc.org",
                                                "code" : "59776-5",
                                                "display" : "Findings"
                                              }]
                                            }
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            224. Composition.section:findings.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()))
                                            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
                                            • 226. Composition.section:findings.entry:finding
                                              Slice Namefinding
                                              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(Finding, Resource)
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              228. Composition.section:findings.entry:keyimage
                                              Slice Namekeyimage
                                              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(Imaging Key Image Document Reference, Key images represented as an ImagingSelection for R4, Resource)
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              230. Composition.section:impression
                                              Slice Nameimpression
                                              Definition

                                              The root of the sections that make up the composition.

                                              ShortImpressionsComposition is broken into sections
                                              Control10..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())
                                              232. Composition.section:impression.extension
                                              Definition

                                              An Extension


                                              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.

                                              ShortExtensionAdditional content defined by implementations
                                              Comments

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

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

                                                Additional notes that apply to this resource or element.

                                                ShortAdditional notes that apply to this resource or element.
                                                Comments

                                                This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                                Control0..*
                                                TypeExtension(Note) (Extension Type: Annotation)
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                ele-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())
                                                236. Composition.section:impression.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.


                                                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())
                                                238. Composition.section:impression.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://loinc.org",
                                                    "code" : "19005-8",
                                                    "display" : "Radiology Imaging study [Impression] (narrative)"
                                                  }]
                                                }
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                240. Composition.section:impression.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()))
                                                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
                                                • 242. Composition.section:impression.entry:finding
                                                  Slice Namefinding
                                                  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(Finding, Resource)
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  244. Composition.section:impression.entry:impression
                                                  Slice Nameimpression
                                                  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(EU Condition, Resource)
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  246. Composition.section:impression.entry:keyimage
                                                  Slice Namekeyimage
                                                  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(Imaging Key Image Document Reference, Key images represented as an ImagingSelection for R4, Resource)
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  248. Composition.section:recommendation
                                                  Slice Namerecommendation
                                                  Definition

                                                  The root of the sections that make up the composition.

                                                  ShortRecommendationsComposition is broken into sections
                                                  Control10..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())
                                                  250. Composition.section:recommendation.extension
                                                  Definition

                                                  An Extension


                                                  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.

                                                  ShortExtensionAdditional content defined by implementations
                                                  Comments

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

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

                                                    Additional notes that apply to this resource or element.

                                                    ShortAdditional notes that apply to this resource or element.
                                                    Comments

                                                    This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                                    Control0..*
                                                    TypeExtension(Note) (Extension Type: Annotation)
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    ele-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())
                                                    254. Composition.section:recommendation.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.


                                                    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())
                                                    256. Composition.section:recommendation.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://loinc.org",
                                                        "code" : "18783-1",
                                                        "display" : "Radiology Study recommendation (narrative)"
                                                      }]
                                                    }
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    258. Composition.section:recommendation.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()))
                                                    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
                                                    • 260. Composition.section:recommendation.entry:careplan
                                                      Slice Namecareplan
                                                      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(EU CarePlan, Resource)
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      262. Composition.section:communication
                                                      Slice Namecommunication
                                                      Definition

                                                      The root of the sections that make up the composition.

                                                      ShortCommunicationsComposition 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())
                                                      264. Composition.section:communication.extension
                                                      Definition

                                                      An Extension


                                                      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.

                                                      ShortExtensionAdditional content defined by implementations
                                                      Comments

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

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

                                                        Additional notes that apply to this resource or element.

                                                        ShortAdditional notes that apply to this resource or element.
                                                        Comments

                                                        This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                                        Control0..*
                                                        TypeExtension(Note) (Extension Type: Annotation)
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        ele-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())
                                                        268. Composition.section:communication.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.


                                                        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())
                                                        270. Composition.section:communication.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://loinc.org",
                                                            "code" : "18783-1",
                                                            "display" : "Radiology Study recommendation (narrative)"
                                                          }]
                                                        }
                                                        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 foundhere

                                                        0. Composition
                                                        Definition

                                                        Imaging Study Report composition.

                                                        A composition is a set of healthcare-related information that is assembled together into a single logical document 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.

                                                        While a Composition defines the structure, it does not actually contain the content: rather the full content of a document is contained in a Bundle, of which the Composition is the first resource contained.

                                                        The text field of each section SHALL contain a textual representation of all listed entries.

                                                        ShortImaging Report composition
                                                        2. Composition.extension
                                                        Control1..?
                                                        4. Composition.extension:diagnosticreport-reference
                                                        Slice Namediagnosticreport-reference
                                                        Control1..1
                                                        TypeExtension(Document DiagnosticReport Reference) (Extension Type: Reference(Imaging Diagnostic Report))
                                                        6. Composition.identifier
                                                        NoteThis is a business identifier, not a resource identifier (see discussion)
                                                        8. Composition.identifier.extension
                                                        Control1..?
                                                        10. Composition.identifier.extension:identifier
                                                        Slice Nameidentifier
                                                        Control1..*
                                                        TypeExtension(Cross-version Extension for R5.Composition.identifier for use in FHIR R4) (Extension Type: Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta)
                                                        12. Composition.type
                                                        BindingUnless not suitable, these codes SHALL be taken from HL7 EU Imaging Report Types
                                                        (extensible to http://hl7.eu/fhir/imaging-r4/ValueSet/ImImagingReportTypesEuVS)
                                                        14. Composition.type.coding
                                                        Control1..?
                                                        SlicingThis element introduces a set of slices on Composition.type.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                        • value @ $this
                                                        • 16. Composition.type.coding:eu-template
                                                          Slice Nameeu-template
                                                          Control1..1
                                                          Pattern Value{
                                                            "system" : "http://hl7.eu/fhir/imaging-r4/CodeSystem/Hl7EuDocumentTypes",
                                                            "code" : "imaging-report-v0-0-1",
                                                            "display" : "Imaging Report V0.0.1"
                                                          }
                                                          18. Composition.category:imaging
                                                          Slice Nameimaging
                                                          Control1..1
                                                          Pattern Value{
                                                            "coding" : [{
                                                              "system" : "http://loinc.org",
                                                              "code" : "18748-4",
                                                              "display" : "Diagnostic imaging study"
                                                            }]
                                                          }
                                                          20. Composition.category:imaging.coding
                                                          Control1..1
                                                          22. Composition.author
                                                          SlicingThis element introduces a set of slices on Composition.author. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                          • profile @ $this
                                                          • 24. Composition.author:author
                                                            Slice Nameauthor
                                                            Control0..*
                                                            TypeReference(PractitionerRole (EU base))
                                                            26. Composition.author:authoringDevice
                                                            Slice NameauthoringDevice
                                                            Control0..*
                                                            TypeReference(Device)
                                                            28. Composition.attester
                                                            SlicingThis element introduces a set of slices on Composition.attester. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                            • value @ mode
                                                            • 30. Composition.attester:legalAuthenticator
                                                              Slice NamelegalAuthenticator
                                                              Control0..*
                                                              32. Composition.attester:legalAuthenticator.mode
                                                              Pattern Valuelegal
                                                              34. Composition.attester:legalAuthenticator.time
                                                              Control1..?
                                                              36. Composition.attester:legalAuthenticator.party
                                                              TypeReference(PractitionerRole (EU base))
                                                              38. Composition.attester:resultValidator
                                                              Slice NameresultValidator
                                                              Control0..*
                                                              40. Composition.attester:resultValidator.mode
                                                              Pattern Valueprofessional
                                                              42. Composition.attester:resultValidator.time
                                                              Control1..?
                                                              44. Composition.attester:resultValidator.party
                                                              TypeReference(PractitionerRole (EU base))
                                                              46. Composition.custodian
                                                              ShortOrganization that manages the Imaging Report
                                                              TypeReference(Organization (EU base))
                                                              48. Composition.event
                                                              Control2..?
                                                              SlicingThis element introduces a set of slices on Composition.event. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                              • value @ detail.concept
                                                              • 50. Composition.event.detail
                                                                52. Composition.event.detail.extension:detailext
                                                                Slice Namedetailext
                                                                Control0..*
                                                                TypeExtension(Cross-version Extension for R5.Composition.event.detail for use in FHIR R4) (Extension Type: Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta)
                                                                54. Composition.event:imagingstudy
                                                                Slice Nameimagingstudy
                                                                Definition

                                                                The type of imaging modality used to perform the study.

                                                                ShortModality
                                                                Control1..*
                                                                56. Composition.event:imagingstudy.detail
                                                                Control1..?
                                                                58. Composition.event:imagingstudy.detail.extension:detailext
                                                                Slice Namedetailext
                                                                Control0..*
                                                                TypeExtension(Cross-version Extension for R5.Composition.event.detail for use in FHIR R4) (Extension Type: Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta)
                                                                60. Composition.event:imagingstudy.detail.extension:detailext.extension:concept
                                                                Slice Nameconcept
                                                                62. Composition.event:imagingstudy.detail.extension:detailext.extension:concept.extension
                                                                Control0..0
                                                                64. Composition.event:imagingstudy.detail.extension:detailext.extension:concept.value[x]
                                                                BindingUnless not suitable, these codes SHALL be taken from https://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_33.html
                                                                (extensible to https://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_33.html)
                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                66. Composition.event:imagingstudy.detail.extension:detailext.extension:reference
                                                                Slice Namereference
                                                                68. Composition.event:imagingstudy.detail.extension:detailext.extension:reference.extension
                                                                Control0..0
                                                                70. Composition.event:imagingstudy.detail.extension:detailext.extension:reference.value[x]
                                                                TypeReference(IM Imaging Study)
                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                72. Composition.event:imagingstudy.detail.extension:detailext.value[x]
                                                                Control0..0
                                                                74. Composition.event:procedure
                                                                Slice Nameprocedure
                                                                Definition

                                                                The type of imaging study performed.

                                                                ShortStudy Type
                                                                Control1..*
                                                                76. Composition.event:procedure.detail
                                                                Control1..?
                                                                78. Composition.event:procedure.detail.extension:detailext
                                                                Slice Namedetailext
                                                                Control0..*
                                                                TypeExtension(Cross-version Extension for R5.Composition.event.detail for use in FHIR R4) (Extension Type: Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta)
                                                                80. Composition.event:procedure.detail.extension:detailext.extension:concept
                                                                Slice Nameconcept
                                                                82. Composition.event:procedure.detail.extension:detailext.extension:concept.extension
                                                                Control0..0
                                                                84. Composition.event:procedure.detail.extension:detailext.extension:concept.value[x]
                                                                BindingUnless not suitable, these codes SHALL be taken from https://www.hl7.org/fhir/valueset-procedure-reason.html
                                                                (extensible to https://www.hl7.org/fhir/valueset-procedure-reason.html)
                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                86. Composition.event:procedure.detail.extension:detailext.extension:reference
                                                                Slice Namereference
                                                                88. Composition.event:procedure.detail.extension:detailext.extension:reference.extension
                                                                Control0..0
                                                                90. Composition.event:procedure.detail.extension:detailext.extension:reference.value[x]
                                                                TypeReference(IM Imaging Procedure)
                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                92. Composition.event:procedure.detail.extension:detailext.value[x]
                                                                Control0..0
                                                                94. Composition.section
                                                                Control8..?
                                                                Invariantseu-imaging-composition-1: When a section is empty, the emptyReason extension SHALL be present. (entry.empty() and emptyReason.exists())
                                                                SlicingThis element introduces a set of slices on Composition.section. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                • value @ code
                                                                • 96. Composition.section.code
                                                                  Control1..?
                                                                  98. Composition.section.emptyReason
                                                                  BindingThe codes SHOULD be taken from Reasons a section in an imaging report is empty.
                                                                  (preferred to http://hl7.eu/fhir/imaging-r4/ValueSet/ImSectionEmptyReason)
                                                                  100. Composition.section:imagingstudy
                                                                  Slice Nameimagingstudy
                                                                  Definition

                                                                  This section holds information related to the imaging studies covered by this report.

                                                                  ShortImaging Study
                                                                  Control1..1
                                                                  102. Composition.section:imagingstudy.extension
                                                                  SlicingThis element introduces a set of slices on Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                  • value @ url
                                                                  • 104. Composition.section:imagingstudy.extension:note
                                                                    Slice Namenote
                                                                    Control0..*
                                                                    TypeExtension(Note) (Extension Type: Annotation)
                                                                    106. Composition.section:imagingstudy.code
                                                                    Pattern Value{
                                                                      "coding" : [{
                                                                        "system" : "http://loinc.org",
                                                                        "code" : "18726-0"
                                                                      }]
                                                                    }
                                                                    108. Composition.section:imagingstudy.entry
                                                                    Control1..?
                                                                    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
                                                                    • 110. Composition.section:imagingstudy.entry:imagingstudy
                                                                      Slice Nameimagingstudy
                                                                      Definition

                                                                      This entry holds a reference to the Imaging Study instance that is associated with this Composition.

                                                                      ShortImaging Study Reference
                                                                      Control1..*
                                                                      TypeReference(IM Imaging Study)
                                                                      112. Composition.section:order
                                                                      Slice Nameorder
                                                                      Definition

                                                                      This section holds information related to the order for the imaging study.

                                                                      ShortOrder
                                                                      Control1..1
                                                                      114. Composition.section:order.extension
                                                                      SlicingThis element introduces a set of slices on Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                      • value @ url
                                                                      • 116. Composition.section:order.extension:note
                                                                        Slice Namenote
                                                                        Control0..*
                                                                        TypeExtension(Note) (Extension Type: Annotation)
                                                                        118. Composition.section:order.code
                                                                        Pattern Value{
                                                                          "coding" : [{
                                                                            "system" : "http://loinc.org",
                                                                            "code" : "55115-0",
                                                                            "display" : "Requested imaging studies information Document"
                                                                          }]
                                                                        }
                                                                        120. Composition.section:order.entry
                                                                        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
                                                                        • 122. Composition.section:order.entry:order
                                                                          Slice Nameorder
                                                                          Definition

                                                                          This entry holds a reference to the order for the Imaging Study and report.

                                                                          ShortOrder reference
                                                                          Control0..*
                                                                          TypeReference(IM Imaging Order)
                                                                          124. Composition.section:history
                                                                          Slice Namehistory
                                                                          ShortHistory
                                                                          Control1..1
                                                                          126. Composition.section:history.extension
                                                                          SlicingThis element introduces a set of slices on Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                          • value @ url
                                                                          • 128. Composition.section:history.extension:note
                                                                            Slice Namenote
                                                                            Control0..*
                                                                            TypeExtension(Note) (Extension Type: Annotation)
                                                                            130. Composition.section:history.code
                                                                            Pattern Value{
                                                                              "coding" : [{
                                                                                "system" : "http://loinc.org",
                                                                                "code" : "11329-0",
                                                                                "display" : "History general Narrative - Reported"
                                                                              }]
                                                                            }
                                                                            132. Composition.section:procedure
                                                                            Slice Nameprocedure
                                                                            ShortProcedure
                                                                            Control1..1
                                                                            134. Composition.section:procedure.extension
                                                                            SlicingThis element introduces a set of slices on Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                            • value @ url
                                                                            • 136. Composition.section:procedure.extension:note
                                                                              Slice Namenote
                                                                              Control0..*
                                                                              TypeExtension(Note) (Extension Type: Annotation)
                                                                              138. Composition.section:procedure.code
                                                                              Pattern Value{
                                                                                "coding" : [{
                                                                                  "system" : "http://loinc.org",
                                                                                  "code" : "55111-9",
                                                                                  "display" : "Current imaging procedure descriptions Document"
                                                                                }]
                                                                              }
                                                                              140. Composition.section:procedure.entry
                                                                              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
                                                                              • 142. Composition.section:procedure.entry:procedure
                                                                                Slice Nameprocedure
                                                                                Control0..*
                                                                                TypeReference(IM Imaging Procedure)
                                                                                144. Composition.section:comparison
                                                                                Slice Namecomparison
                                                                                ShortHistory
                                                                                Control1..1
                                                                                146. Composition.section:comparison.extension
                                                                                SlicingThis element introduces a set of slices on Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                • value @ url
                                                                                • 148. Composition.section:comparison.extension:note
                                                                                  Slice Namenote
                                                                                  Control0..*
                                                                                  TypeExtension(Note) (Extension Type: Annotation)
                                                                                  150. Composition.section:comparison.code
                                                                                  Pattern Value{
                                                                                    "coding" : [{
                                                                                      "system" : "http://loinc.org",
                                                                                      "code" : "18834-2",
                                                                                      "display" : "Radiology Comparison study (narrative)"
                                                                                    }]
                                                                                  }
                                                                                  152. Composition.section:comparison.entry
                                                                                  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
                                                                                  • 154. Composition.section:comparison.entry:comparedstudy
                                                                                    Slice Namecomparedstudy
                                                                                    Control0..*
                                                                                    TypeReference(IM Imaging Study, Imaging Selection profile for R4)
                                                                                    156. Composition.section:findings
                                                                                    Slice Namefindings
                                                                                    ShortFindings
                                                                                    Control1..1
                                                                                    158. Composition.section:findings.extension
                                                                                    SlicingThis element introduces a set of slices on Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                    • value @ url
                                                                                    • 160. Composition.section:findings.extension:note
                                                                                      Slice Namenote
                                                                                      Control0..*
                                                                                      TypeExtension(Note) (Extension Type: Annotation)
                                                                                      162. Composition.section:findings.code
                                                                                      Pattern Value{
                                                                                        "coding" : [{
                                                                                          "system" : "http://loinc.org",
                                                                                          "code" : "59776-5",
                                                                                          "display" : "Findings"
                                                                                        }]
                                                                                      }
                                                                                      164. Composition.section:findings.entry
                                                                                      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
                                                                                      • 166. Composition.section:findings.entry:finding
                                                                                        Slice Namefinding
                                                                                        Control0..*
                                                                                        TypeReference(Finding)
                                                                                        168. Composition.section:findings.entry:keyimage
                                                                                        Slice Namekeyimage
                                                                                        Control0..*
                                                                                        TypeReference(Imaging Key Image Document Reference, Key images represented as an ImagingSelection for R4)
                                                                                        170. Composition.section:impression
                                                                                        Slice Nameimpression
                                                                                        ShortImpressions
                                                                                        Control1..1
                                                                                        172. Composition.section:impression.extension
                                                                                        SlicingThis element introduces a set of slices on Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                        • value @ url
                                                                                        • 174. Composition.section:impression.extension:note
                                                                                          Slice Namenote
                                                                                          Control0..*
                                                                                          TypeExtension(Note) (Extension Type: Annotation)
                                                                                          176. Composition.section:impression.code
                                                                                          Pattern Value{
                                                                                            "coding" : [{
                                                                                              "system" : "http://loinc.org",
                                                                                              "code" : "19005-8",
                                                                                              "display" : "Radiology Imaging study [Impression] (narrative)"
                                                                                            }]
                                                                                          }
                                                                                          178. Composition.section:impression.entry
                                                                                          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
                                                                                          • 180. Composition.section:impression.entry:finding
                                                                                            Slice Namefinding
                                                                                            Control0..*
                                                                                            TypeReference(Finding)
                                                                                            182. Composition.section:impression.entry:impression
                                                                                            Slice Nameimpression
                                                                                            Control0..*
                                                                                            TypeReference(EU Condition)
                                                                                            184. Composition.section:impression.entry:keyimage
                                                                                            Slice Namekeyimage
                                                                                            Control0..*
                                                                                            TypeReference(Imaging Key Image Document Reference, Key images represented as an ImagingSelection for R4)
                                                                                            186. Composition.section:recommendation
                                                                                            Slice Namerecommendation
                                                                                            ShortRecommendations
                                                                                            Control1..1
                                                                                            188. Composition.section:recommendation.extension
                                                                                            SlicingThis element introduces a set of slices on Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                            • value @ url
                                                                                            • 190. Composition.section:recommendation.extension:note
                                                                                              Slice Namenote
                                                                                              Control0..*
                                                                                              TypeExtension(Note) (Extension Type: Annotation)
                                                                                              192. Composition.section:recommendation.code
                                                                                              Pattern Value{
                                                                                                "coding" : [{
                                                                                                  "system" : "http://loinc.org",
                                                                                                  "code" : "18783-1",
                                                                                                  "display" : "Radiology Study recommendation (narrative)"
                                                                                                }]
                                                                                              }
                                                                                              194. Composition.section:recommendation.entry
                                                                                              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
                                                                                              • 196. Composition.section:recommendation.entry:careplan
                                                                                                Slice Namecareplan
                                                                                                Control0..*
                                                                                                TypeReference(EU CarePlan)
                                                                                                198. Composition.section:communication
                                                                                                Slice Namecommunication
                                                                                                ShortCommunications
                                                                                                Control0..1
                                                                                                200. Composition.section:communication.extension
                                                                                                SlicingThis element introduces a set of slices on Composition.section.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                • value @ url
                                                                                                • 202. Composition.section:communication.extension:note
                                                                                                  Slice Namenote
                                                                                                  Control0..*
                                                                                                  TypeExtension(Note) (Extension Type: Annotation)
                                                                                                  204. Composition.section:communication.code
                                                                                                  Pattern Value{
                                                                                                    "coding" : [{
                                                                                                      "system" : "http://loinc.org",
                                                                                                      "code" : "18783-1",
                                                                                                      "display" : "Radiology Study recommendation (narrative)"
                                                                                                    }]
                                                                                                  }

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

                                                                                                  0. Composition
                                                                                                  Definition

                                                                                                  Imaging Study Report composition.

                                                                                                  A composition is a set of healthcare-related information that is assembled together into a single logical document 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.

                                                                                                  While a Composition defines the structure, it does not actually contain the content: rather the full content of a document is contained in a Bundle, of which the Composition is the first resource contained.

                                                                                                  The text field of each section SHALL contain a textual representation of all listed entries.

                                                                                                  ShortImaging Report composition
                                                                                                  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

                                                                                                  An Extension

                                                                                                  ShortExtension
                                                                                                  Control1..*
                                                                                                  TypeExtension
                                                                                                  Is Modifierfalse
                                                                                                  Summaryfalse
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                  SlicingThis element introduces a set of slices on Composition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                  • value @ url
                                                                                                  • 16. Composition.extension:versionNumber
                                                                                                    Slice NameversionNumber
                                                                                                    Definition

                                                                                                    Version specific identifier for the composition, assigned when each version is created/updated.

                                                                                                    ShortVersion-specific identifier for composition
                                                                                                    Comments

                                                                                                    While each resource, including the composition itself, has its own version identifier, this is a formal identifier for the logical version of the composition as a whole. It would remain constant if the resources were moved to a new server, and all got new individual resource versions, for example.

                                                                                                    Control0..*
                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                    TypeExtension(Composition Version Number) (Extension Type: string)
                                                                                                    Is Modifierfalse
                                                                                                    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.extension:basedOn
                                                                                                    Slice NamebasedOn
                                                                                                    Definition

                                                                                                    A plan, proposal or order that is fulfilled in whole or in part by this event.

                                                                                                    ShortFulfills plan, proposal or order
                                                                                                    Control0..*
                                                                                                    TypeExtension(Based on) (Extension Type: Reference(Resource))
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                    20. Composition.extension:informationRecipient
                                                                                                    Slice NameinformationRecipient
                                                                                                    Definition

                                                                                                    This extension applies to the Composition resource and is used to represent an intended recipient of the composition.

                                                                                                    ShortComposition: Information recipient
                                                                                                    Control0..*
                                                                                                    TypeExtension(Composition: Information recipient) (Extension Type: Reference(Practitioner, Device, Patient, RelatedPerson, PractitionerRole, Organization))
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                    22. Composition.extension:diagnosticreport-reference
                                                                                                    Slice Namediagnosticreport-reference
                                                                                                    Definition

                                                                                                    This extension provides a reference to the DiagnosticReport instance that is associated with this Composition.

                                                                                                    ShortDocument DiagnosticReport Reference
                                                                                                    Control1..1
                                                                                                    TypeExtension(Document DiagnosticReport Reference) (Extension Type: Reference(Imaging Diagnostic Report))
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                    24. 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())
                                                                                                    26. Composition.identifier
                                                                                                    Definition

                                                                                                    Identifiers assigned to this report by the performer or other systems. It shall be common to several report versions

                                                                                                    ShortReport identifier
                                                                                                    Comments

                                                                                                    Composition.identifier SHALL be equal to one of the DiagnosticReport.identifier, if at least one exists

                                                                                                    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()))
                                                                                                    28. Composition.identifier.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
                                                                                                    30. Composition.identifier.extension
                                                                                                    Definition

                                                                                                    An Extension

                                                                                                    ShortExtension
                                                                                                    Control1..*
                                                                                                    TypeExtension
                                                                                                    Is Modifierfalse
                                                                                                    Summaryfalse
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                    SlicingThis element introduces a set of slices on Composition.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                    • value @ url
                                                                                                    • 32. Composition.identifier.extension:identifier
                                                                                                      Slice Nameidentifier
                                                                                                      Definition

                                                                                                      Optional Extension Element - found in all resources.

                                                                                                      ShortOptional Extensions Element
                                                                                                      Control1..*
                                                                                                      TypeExtension(Cross-version Extension for R5.Composition.identifier for use in FHIR R4) (Extension Type: Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta)
                                                                                                      Is Modifierfalse
                                                                                                      Summaryfalse
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                      34. Composition.identifier.use
                                                                                                      Definition

                                                                                                      The purpose of this identifier.

                                                                                                      Shortusual | official | temp | secondary | old (If known)
                                                                                                      Comments

                                                                                                      Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                                                                                                      Control0..1
                                                                                                      BindingThe codes SHALL be taken from IdentifierUse
                                                                                                      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                                                                                                      Identifies the purpose for this identifier, if known .

                                                                                                      Typecode
                                                                                                      Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                      Summarytrue
                                                                                                      Requirements

                                                                                                      Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

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

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

                                                                                                      ShortDescription of identifier
                                                                                                      Comments

                                                                                                      This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                                                                                                      Control0..1
                                                                                                      BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                                                                                                      (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

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

                                                                                                      TypeCodeableConcept
                                                                                                      Is Modifierfalse
                                                                                                      Summarytrue
                                                                                                      Requirements

                                                                                                      Allows users to make use of identifiers when the identifier system is not known.

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

                                                                                                      Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                                                                                                      ShortThe namespace for the identifier value
                                                                                                      Comments

                                                                                                      Identifier.system is always case sensitive.

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

                                                                                                      There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                                                                                                      Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      40. Composition.identifier.value
                                                                                                      Definition

                                                                                                      The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                                                                                                      ShortThe value that is unique
                                                                                                      Comments

                                                                                                      If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                                                                                                      Control0..1
                                                                                                      Typestring
                                                                                                      Is Modifierfalse
                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                      Summarytrue
                                                                                                      Example<br/><b>General</b>:123456
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      42. Composition.identifier.period
                                                                                                      Definition

                                                                                                      Time period during which identifier is/was valid for use.

                                                                                                      ShortTime period when id is/was valid for use
                                                                                                      Control0..1
                                                                                                      TypePeriod
                                                                                                      Is Modifierfalse
                                                                                                      Summarytrue
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      44. Composition.identifier.assigner
                                                                                                      Definition

                                                                                                      Organization that issued/manages the identifier.

                                                                                                      ShortOrganization that issued id (may be just text)
                                                                                                      Comments

                                                                                                      The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                                                                                                      Control0..1
                                                                                                      TypeReference(Organization)
                                                                                                      Is Modifierfalse
                                                                                                      Summarytrue
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      46. 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()))
                                                                                                      48. Composition.type
                                                                                                      Definition

                                                                                                      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.

                                                                                                      ShortKind 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
                                                                                                      BindingUnless not suitable, these codes SHALL be taken from HL7 EU Imaging Report Types
                                                                                                      (extensible to http://hl7.eu/fhir/imaging-r4/ValueSet/ImImagingReportTypesEuVS)
                                                                                                      TypeCodeableConcept
                                                                                                      Is Modifierfalse
                                                                                                      Summarytrue
                                                                                                      Requirements

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

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

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

                                                                                                      ShortAdditional content defined by implementations
                                                                                                      Comments

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

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

                                                                                                        A reference to a code defined by a terminology system.

                                                                                                        ShortCode defined by a terminology system
                                                                                                        Comments

                                                                                                        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                                                        Control1..*
                                                                                                        TypeCoding
                                                                                                        Is Modifierfalse
                                                                                                        Summarytrue
                                                                                                        Requirements

                                                                                                        Allows for alternative encodings within a code system, and translations to other code systems.

                                                                                                        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.type.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                        • value @ $this
                                                                                                        • 56. Composition.type.coding:eu-template
                                                                                                          Slice Nameeu-template
                                                                                                          Definition

                                                                                                          A reference to a code defined by a terminology system.

                                                                                                          ShortCode defined by a terminology system
                                                                                                          Comments

                                                                                                          Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                                                          Control1..1
                                                                                                          TypeCoding
                                                                                                          Is Modifierfalse
                                                                                                          Summarytrue
                                                                                                          Requirements

                                                                                                          Allows for alternative encodings within a code system, and translations to other code systems.

                                                                                                          Pattern Value{
                                                                                                            "system" : "http://hl7.eu/fhir/imaging-r4/CodeSystem/Hl7EuDocumentTypes",
                                                                                                            "code" : "imaging-report-v0-0-1",
                                                                                                            "display" : "Imaging Report V0.0.1"
                                                                                                          }
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          58. Composition.type.text
                                                                                                          Definition

                                                                                                          A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                                                          ShortPlain text representation of the concept
                                                                                                          Comments

                                                                                                          Very often the text is the same as a displayName of one of the codings.

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

                                                                                                          The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          60. 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.

                                                                                                          Control1..*
                                                                                                          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()))
                                                                                                          SlicingThis element introduces a set of slices on Composition.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                          • value @ $this
                                                                                                          • 62. Composition.category:imaging
                                                                                                            Slice Nameimaging
                                                                                                            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.

                                                                                                            Control1..1
                                                                                                            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.

                                                                                                            Pattern Value{
                                                                                                              "coding" : [{
                                                                                                                "system" : "http://loinc.org",
                                                                                                                "code" : "18748-4",
                                                                                                                "display" : "Diagnostic imaging study"
                                                                                                              }]
                                                                                                            }
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            64. Composition.category:imaging.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
                                                                                                            66. Composition.category:imaging.extension
                                                                                                            Definition

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

                                                                                                            ShortAdditional content defined by implementations
                                                                                                            Comments

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

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

                                                                                                              A reference to a code defined by a terminology system.

                                                                                                              ShortCode defined by a terminology system
                                                                                                              Comments

                                                                                                              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                                                              Control1..1
                                                                                                              TypeCoding
                                                                                                              Is Modifierfalse
                                                                                                              Summarytrue
                                                                                                              Requirements

                                                                                                              Allows for alternative encodings within a code system, and translations to other code systems.

                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              70. Composition.category:imaging.text
                                                                                                              Definition

                                                                                                              A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                                                              ShortPlain text representation of the concept
                                                                                                              Comments

                                                                                                              Very often the text is the same as a displayName of one of the codings.

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

                                                                                                              The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              72. 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, Practitioner, Group, Device, Location)
                                                                                                              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()))
                                                                                                              74. 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()))
                                                                                                              76. 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()))
                                                                                                              78. Composition.author
                                                                                                              Definition

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

                                                                                                              ShortWho and/or what authored the composition
                                                                                                              Control1..*
                                                                                                              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()))
                                                                                                              SlicingThis element introduces a set of slices on Composition.author. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                              • profile @ $this
                                                                                                              • 80. Composition.author:author
                                                                                                                Slice Nameauthor
                                                                                                                Definition

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

                                                                                                                ShortWho and/or what authored the composition
                                                                                                                Control0..*
                                                                                                                TypeReference(PractitionerRole (EU base))
                                                                                                                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()))
                                                                                                                82. Composition.author:authoringDevice
                                                                                                                Slice NameauthoringDevice
                                                                                                                Definition

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

                                                                                                                ShortWho and/or what authored the composition
                                                                                                                Control0..*
                                                                                                                TypeReference(Device)
                                                                                                                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()))
                                                                                                                84. 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()))
                                                                                                                86. 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()))
                                                                                                                88. 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()))
                                                                                                                SlicingThis element introduces a set of slices on Composition.attester. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                • value @ mode
                                                                                                                • 90. 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
                                                                                                                  92. 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())
                                                                                                                  94. 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())
                                                                                                                  96. 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()))
                                                                                                                  98. 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()))
                                                                                                                  100. 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()))
                                                                                                                  102. Composition.attester:legalAuthenticator
                                                                                                                  Slice NamelegalAuthenticator
                                                                                                                  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()))
                                                                                                                  104. Composition.attester:legalAuthenticator.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
                                                                                                                  106. Composition.attester:legalAuthenticator.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())
                                                                                                                  108. Composition.attester:legalAuthenticator.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())
                                                                                                                  110. Composition.attester:legalAuthenticator.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.

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

                                                                                                                  When the composition was attested by the party.

                                                                                                                  ShortWhen the composition was attested
                                                                                                                  Control1..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()))
                                                                                                                  114. Composition.attester:legalAuthenticator.party
                                                                                                                  Definition

                                                                                                                  Who attested the composition in the specified way.

                                                                                                                  ShortWho attested the composition
                                                                                                                  Control0..1
                                                                                                                  TypeReference(PractitionerRole (EU base))
                                                                                                                  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()))
                                                                                                                  116. Composition.attester:resultValidator
                                                                                                                  Slice NameresultValidator
                                                                                                                  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()))
                                                                                                                  118. Composition.attester:resultValidator.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
                                                                                                                  120. Composition.attester:resultValidator.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())
                                                                                                                  122. Composition.attester:resultValidator.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())
                                                                                                                  124. Composition.attester:resultValidator.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.

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

                                                                                                                  When the composition was attested by the party.

                                                                                                                  ShortWhen the composition was attested
                                                                                                                  Control1..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()))
                                                                                                                  128. Composition.attester:resultValidator.party
                                                                                                                  Definition

                                                                                                                  Who attested the composition in the specified way.

                                                                                                                  ShortWho attested the composition
                                                                                                                  Control0..1
                                                                                                                  TypeReference(PractitionerRole (EU base))
                                                                                                                  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()))
                                                                                                                  130. Composition.custodian
                                                                                                                  Definition

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

                                                                                                                  ShortOrganization that manages the Imaging Report
                                                                                                                  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 (EU base))
                                                                                                                  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()))
                                                                                                                  132. 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()))
                                                                                                                  134. 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
                                                                                                                  136. 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())
                                                                                                                  138. 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())
                                                                                                                  140. 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()))
                                                                                                                  142. 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()))
                                                                                                                  144. 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.

                                                                                                                  Control2..*
                                                                                                                  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()))
                                                                                                                  SlicingThis element introduces a set of slices on Composition.event. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                  • value @ detail.concept
                                                                                                                  • 146. 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
                                                                                                                    148. 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())
                                                                                                                    150. 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())
                                                                                                                    152. 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()))
                                                                                                                    154. 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()))
                                                                                                                    156. 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()))
                                                                                                                    158. Composition.event.detail.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
                                                                                                                    160. Composition.event.detail.extension
                                                                                                                    Definition

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

                                                                                                                    ShortAdditional content defined by implementations
                                                                                                                    Comments

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

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

                                                                                                                      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 case the procedure being documented is necessarily a "History and Physical" act. The events may be included as a code or as a reference to an other resource.

                                                                                                                      ShortThe event(s) being documented, as code(s), reference(s), or both
                                                                                                                      Comments

                                                                                                                      Composition.event.detail maps to R4 Composition.event.detail. So is mapped as Equivalent.

                                                                                                                      Control0..*
                                                                                                                      TypeExtension(Cross-version Extension for R5.Composition.event.detail for use in FHIR R4) (Extension Type: Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta)
                                                                                                                      Is Modifierfalse
                                                                                                                      Summaryfalse
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                      164. Composition.event.detail.reference
                                                                                                                      Definition

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

                                                                                                                      ShortLiteral reference, Relative, internal or absolute URL
                                                                                                                      Comments

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

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

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

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

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

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

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

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

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

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

                                                                                                                      ShortLogical reference, when literal reference is not known
                                                                                                                      Comments

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

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

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

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

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

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

                                                                                                                      ShortText alternative for the resource
                                                                                                                      Comments

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

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

                                                                                                                      The type of imaging modality used to perform the study.

                                                                                                                      ShortModality
                                                                                                                      Comments

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

                                                                                                                      Control1..*
                                                                                                                      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()))
                                                                                                                      174. Composition.event:imagingstudy.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
                                                                                                                      176. Composition.event:imagingstudy.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())
                                                                                                                      178. Composition.event:imagingstudy.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())
                                                                                                                      180. Composition.event:imagingstudy.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()))
                                                                                                                      182. Composition.event:imagingstudy.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()))
                                                                                                                      184. Composition.event:imagingstudy.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
                                                                                                                      Control1..*
                                                                                                                      TypeReference(Resource)
                                                                                                                      Is Modifierfalse
                                                                                                                      Summarytrue
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      186. Composition.event:imagingstudy.detail.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
                                                                                                                      188. Composition.event:imagingstudy.detail.extension
                                                                                                                      Definition

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

                                                                                                                      ShortAdditional content defined by implementations
                                                                                                                      Comments

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

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

                                                                                                                        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 case the procedure being documented is necessarily a "History and Physical" act. The events may be included as a code or as a reference to an other resource.

                                                                                                                        ShortThe event(s) being documented, as code(s), reference(s), or both
                                                                                                                        Comments

                                                                                                                        Composition.event.detail maps to R4 Composition.event.detail. So is mapped as Equivalent.

                                                                                                                        Control0..*
                                                                                                                        TypeExtension(Cross-version Extension for R5.Composition.event.detail for use in FHIR R4) (Extension Type: Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta)
                                                                                                                        Is Modifierfalse
                                                                                                                        Summaryfalse
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                        192. Composition.event:imagingstudy.detail.extension:detailext.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
                                                                                                                        Typeid
                                                                                                                        Is Modifierfalse
                                                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                        Summaryfalse
                                                                                                                        194. Composition.event:imagingstudy.detail.extension:detailext.extension
                                                                                                                        Definition

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

                                                                                                                        ShortAdditional content defined by implementations
                                                                                                                        Comments

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

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

                                                                                                                          Data type name for Composition.event.detail from FHIR R5

                                                                                                                          ShortData type name for Composition.event.detail from FHIR R5
                                                                                                                          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..1
                                                                                                                          TypeExtension(Datatype) (Extension Type: string)
                                                                                                                          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())
                                                                                                                          198. Composition.event:imagingstudy.detail.extension:detailext.extension:_datatype.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
                                                                                                                          Typeid
                                                                                                                          Is Modifierfalse
                                                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                          Summaryfalse
                                                                                                                          200. Composition.event:imagingstudy.detail.extension:detailext.extension:_datatype.extension
                                                                                                                          Definition

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

                                                                                                                          ShortAdditional content defined by implementations
                                                                                                                          Comments

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

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

                                                                                                                            Source of the definition for the extension code - a logical name or a URL.

                                                                                                                            Shortidentifies the meaning of the extension
                                                                                                                            Comments

                                                                                                                            The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                                                                            Control1..1
                                                                                                                            Typeuri
                                                                                                                            Is Modifierfalse
                                                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                            Summaryfalse
                                                                                                                            Fixed Valuehttp://hl7.org/fhir/StructureDefinition/_datatype
                                                                                                                            204. Composition.event:imagingstudy.detail.extension:detailext.extension:_datatype.value[x]
                                                                                                                            Definition

                                                                                                                            Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                                                                                            ShortValue of extension
                                                                                                                            Comments

                                                                                                                            Must be: CodeableReference

                                                                                                                            Control1..1
                                                                                                                            Typestring
                                                                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                            Is Modifierfalse
                                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                            Summaryfalse
                                                                                                                            Fixed ValueCodeableReference
                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            206. Composition.event:imagingstudy.detail.extension:detailext.extension:concept
                                                                                                                            Slice Nameconcept
                                                                                                                            Definition

                                                                                                                            An Extension

                                                                                                                            ShortExtension
                                                                                                                            Control0..1
                                                                                                                            TypeExtension
                                                                                                                            Is Modifierfalse
                                                                                                                            Summaryfalse
                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                            208. Composition.event:imagingstudy.detail.extension:detailext.extension:concept.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
                                                                                                                            Typeid
                                                                                                                            Is Modifierfalse
                                                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                            Summaryfalse
                                                                                                                            210. Composition.event:imagingstudy.detail.extension:detailext.extension:concept.extension
                                                                                                                            Definition

                                                                                                                            An Extension

                                                                                                                            ShortExtension
                                                                                                                            Control0..0
                                                                                                                            TypeExtension
                                                                                                                            Is Modifierfalse
                                                                                                                            Summaryfalse
                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                            SlicingThis element introduces a set of slices on Composition.event.detail.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                            • value @ url
                                                                                                                            • 212. Composition.event:imagingstudy.detail.extension:detailext.extension:concept.url
                                                                                                                              Definition

                                                                                                                              Source of the definition for the extension code - a logical name or a URL.

                                                                                                                              Shortidentifies the meaning of the extension
                                                                                                                              Comments

                                                                                                                              The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                                                                              Control1..1
                                                                                                                              Typeuri
                                                                                                                              Is Modifierfalse
                                                                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                              Summaryfalse
                                                                                                                              Fixed Valueconcept
                                                                                                                              214. Composition.event:imagingstudy.detail.extension:detailext.extension:concept.value[x]
                                                                                                                              Definition

                                                                                                                              A reference to a concept - e.g. the information is identified by its general class to the degree of precision found in the terminology.

                                                                                                                              ShortReference to a concept (by class)
                                                                                                                              Comments

                                                                                                                              Composition.event.detail maps to R4 Composition.event.detail. So is mapped as Equivalent.

                                                                                                                              Control0..1
                                                                                                                              BindingUnless not suitable, these codes SHALL be taken from https://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_33.html
                                                                                                                              (extensible to https://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_33.html)
                                                                                                                              TypeCodeableConcept
                                                                                                                              [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()))
                                                                                                                              216. Composition.event:imagingstudy.detail.extension:detailext.extension:reference
                                                                                                                              Slice Namereference
                                                                                                                              Definition

                                                                                                                              An Extension

                                                                                                                              ShortExtension
                                                                                                                              Control0..1
                                                                                                                              TypeExtension
                                                                                                                              Is Modifierfalse
                                                                                                                              Summaryfalse
                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                              218. Composition.event:imagingstudy.detail.extension:detailext.extension:reference.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
                                                                                                                              Typeid
                                                                                                                              Is Modifierfalse
                                                                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                              Summaryfalse
                                                                                                                              220. Composition.event:imagingstudy.detail.extension:detailext.extension:reference.extension
                                                                                                                              Definition

                                                                                                                              An Extension

                                                                                                                              ShortExtension
                                                                                                                              Control0..0
                                                                                                                              TypeExtension
                                                                                                                              Is Modifierfalse
                                                                                                                              Summaryfalse
                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                              SlicingThis element introduces a set of slices on Composition.event.detail.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                              • value @ url
                                                                                                                              • 222. Composition.event:imagingstudy.detail.extension:detailext.extension:reference.url
                                                                                                                                Definition

                                                                                                                                Source of the definition for the extension code - a logical name or a URL.

                                                                                                                                Shortidentifies the meaning of the extension
                                                                                                                                Comments

                                                                                                                                The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                                                                                Control1..1
                                                                                                                                Typeuri
                                                                                                                                Is Modifierfalse
                                                                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                Summaryfalse
                                                                                                                                Fixed Valuereference
                                                                                                                                224. Composition.event:imagingstudy.detail.extension:detailext.extension:reference.value[x]
                                                                                                                                Definition

                                                                                                                                A reference to a resource the provides exact details about the information being referenced.

                                                                                                                                ShortReference to a resource (by instance)
                                                                                                                                Comments

                                                                                                                                Composition.event.detail maps to R4 Composition.event.detail. So is mapped as Equivalent.

                                                                                                                                Control0..1
                                                                                                                                TypeReference(IM Imaging Study)
                                                                                                                                [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()))
                                                                                                                                226. Composition.event:imagingstudy.detail.extension:detailext.url
                                                                                                                                Definition

                                                                                                                                Source of the definition for the extension code - a logical name or a URL.

                                                                                                                                Shortidentifies the meaning of the extension
                                                                                                                                Comments

                                                                                                                                The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                                                                                Control1..1
                                                                                                                                Typeuri
                                                                                                                                Is Modifierfalse
                                                                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                Summaryfalse
                                                                                                                                Fixed Valuehttp://hl7.org/fhir/5.0/StructureDefinition/extension-Composition.event.detail
                                                                                                                                228. Composition.event:imagingstudy.detail.extension:detailext.value[x]
                                                                                                                                Definition

                                                                                                                                Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                                                                                                ShortValue of extension
                                                                                                                                Control0..0
                                                                                                                                TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                                                                                                                                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()))
                                                                                                                                230. Composition.event:imagingstudy.detail.reference
                                                                                                                                Definition

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

                                                                                                                                ShortLiteral reference, Relative, internal or absolute URL
                                                                                                                                Comments

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

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

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

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

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

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

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

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

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

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

                                                                                                                                ShortLogical reference, when literal reference is not known
                                                                                                                                Comments

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

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

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

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

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

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

                                                                                                                                ShortText alternative for the resource
                                                                                                                                Comments

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

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

                                                                                                                                The type of imaging study performed.

                                                                                                                                ShortStudy Type
                                                                                                                                Comments

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

                                                                                                                                Control1..*
                                                                                                                                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()))
                                                                                                                                240. Composition.event:procedure.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
                                                                                                                                242. Composition.event:procedure.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())
                                                                                                                                244. Composition.event:procedure.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())
                                                                                                                                246. Composition.event:procedure.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()))
                                                                                                                                248. Composition.event:procedure.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()))
                                                                                                                                250. Composition.event:procedure.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
                                                                                                                                Control1..*
                                                                                                                                TypeReference(Resource)
                                                                                                                                Is Modifierfalse
                                                                                                                                Summarytrue
                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                252. Composition.event:procedure.detail.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
                                                                                                                                254. Composition.event:procedure.detail.extension
                                                                                                                                Definition

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

                                                                                                                                ShortAdditional content defined by implementations
                                                                                                                                Comments

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

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

                                                                                                                                  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 case the procedure being documented is necessarily a "History and Physical" act. The events may be included as a code or as a reference to an other resource.

                                                                                                                                  ShortThe event(s) being documented, as code(s), reference(s), or both
                                                                                                                                  Comments

                                                                                                                                  Composition.event.detail maps to R4 Composition.event.detail. So is mapped as Equivalent.

                                                                                                                                  Control0..*
                                                                                                                                  TypeExtension(Cross-version Extension for R5.Composition.event.detail for use in FHIR R4) (Extension Type: Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta)
                                                                                                                                  Is Modifierfalse
                                                                                                                                  Summaryfalse
                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                  258. Composition.event:procedure.detail.extension:detailext.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
                                                                                                                                  Typeid
                                                                                                                                  Is Modifierfalse
                                                                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                  Summaryfalse
                                                                                                                                  260. Composition.event:procedure.detail.extension:detailext.extension
                                                                                                                                  Definition

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

                                                                                                                                  ShortAdditional content defined by implementations
                                                                                                                                  Comments

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

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

                                                                                                                                    Data type name for Composition.event.detail from FHIR R5

                                                                                                                                    ShortData type name for Composition.event.detail from FHIR R5
                                                                                                                                    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..1
                                                                                                                                    TypeExtension(Datatype) (Extension Type: string)
                                                                                                                                    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())
                                                                                                                                    264. Composition.event:procedure.detail.extension:detailext.extension:_datatype.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
                                                                                                                                    Typeid
                                                                                                                                    Is Modifierfalse
                                                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                    Summaryfalse
                                                                                                                                    266. Composition.event:procedure.detail.extension:detailext.extension:_datatype.extension
                                                                                                                                    Definition

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

                                                                                                                                    ShortAdditional content defined by implementations
                                                                                                                                    Comments

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

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

                                                                                                                                      Source of the definition for the extension code - a logical name or a URL.

                                                                                                                                      Shortidentifies the meaning of the extension
                                                                                                                                      Comments

                                                                                                                                      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                                                                                      Control1..1
                                                                                                                                      Typeuri
                                                                                                                                      Is Modifierfalse
                                                                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                      Summaryfalse
                                                                                                                                      Fixed Valuehttp://hl7.org/fhir/StructureDefinition/_datatype
                                                                                                                                      270. Composition.event:procedure.detail.extension:detailext.extension:_datatype.value[x]
                                                                                                                                      Definition

                                                                                                                                      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                                                                                                      ShortValue of extension
                                                                                                                                      Comments

                                                                                                                                      Must be: CodeableReference

                                                                                                                                      Control1..1
                                                                                                                                      Typestring
                                                                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                      Is Modifierfalse
                                                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                      Summaryfalse
                                                                                                                                      Fixed ValueCodeableReference
                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                      272. Composition.event:procedure.detail.extension:detailext.extension:concept
                                                                                                                                      Slice Nameconcept
                                                                                                                                      Definition

                                                                                                                                      An Extension

                                                                                                                                      ShortExtension
                                                                                                                                      Control0..1
                                                                                                                                      TypeExtension
                                                                                                                                      Is Modifierfalse
                                                                                                                                      Summaryfalse
                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                      274. Composition.event:procedure.detail.extension:detailext.extension:concept.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
                                                                                                                                      Typeid
                                                                                                                                      Is Modifierfalse
                                                                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                      Summaryfalse
                                                                                                                                      276. Composition.event:procedure.detail.extension:detailext.extension:concept.extension
                                                                                                                                      Definition

                                                                                                                                      An Extension

                                                                                                                                      ShortExtension
                                                                                                                                      Control0..0
                                                                                                                                      TypeExtension
                                                                                                                                      Is Modifierfalse
                                                                                                                                      Summaryfalse
                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                      SlicingThis element introduces a set of slices on Composition.event.detail.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                      • value @ url
                                                                                                                                      • 278. Composition.event:procedure.detail.extension:detailext.extension:concept.url
                                                                                                                                        Definition

                                                                                                                                        Source of the definition for the extension code - a logical name or a URL.

                                                                                                                                        Shortidentifies the meaning of the extension
                                                                                                                                        Comments

                                                                                                                                        The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                                                                                        Control1..1
                                                                                                                                        Typeuri
                                                                                                                                        Is Modifierfalse
                                                                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                        Summaryfalse
                                                                                                                                        Fixed Valueconcept
                                                                                                                                        280. Composition.event:procedure.detail.extension:detailext.extension:concept.value[x]
                                                                                                                                        Definition

                                                                                                                                        A reference to a concept - e.g. the information is identified by its general class to the degree of precision found in the terminology.

                                                                                                                                        ShortReference to a concept (by class)
                                                                                                                                        Comments

                                                                                                                                        Composition.event.detail maps to R4 Composition.event.detail. So is mapped as Equivalent.

                                                                                                                                        Control0..1
                                                                                                                                        BindingUnless not suitable, these codes SHALL be taken from https://www.hl7.org/fhir/valueset-procedure-reason.html
                                                                                                                                        (extensible to https://www.hl7.org/fhir/valueset-procedure-reason.html)
                                                                                                                                        TypeCodeableConcept
                                                                                                                                        [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()))
                                                                                                                                        282. Composition.event:procedure.detail.extension:detailext.extension:reference
                                                                                                                                        Slice Namereference
                                                                                                                                        Definition

                                                                                                                                        An Extension

                                                                                                                                        ShortExtension
                                                                                                                                        Control0..1
                                                                                                                                        TypeExtension
                                                                                                                                        Is Modifierfalse
                                                                                                                                        Summaryfalse
                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                        284. Composition.event:procedure.detail.extension:detailext.extension:reference.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
                                                                                                                                        Typeid
                                                                                                                                        Is Modifierfalse
                                                                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                        Summaryfalse
                                                                                                                                        286. Composition.event:procedure.detail.extension:detailext.extension:reference.extension
                                                                                                                                        Definition

                                                                                                                                        An Extension

                                                                                                                                        ShortExtension
                                                                                                                                        Control0..0
                                                                                                                                        TypeExtension
                                                                                                                                        Is Modifierfalse
                                                                                                                                        Summaryfalse
                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                        SlicingThis element introduces a set of slices on Composition.event.detail.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                        • value @ url
                                                                                                                                        • 288. Composition.event:procedure.detail.extension:detailext.extension:reference.url
                                                                                                                                          Definition

                                                                                                                                          Source of the definition for the extension code - a logical name or a URL.

                                                                                                                                          Shortidentifies the meaning of the extension
                                                                                                                                          Comments

                                                                                                                                          The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                                                                                          Control1..1
                                                                                                                                          Typeuri
                                                                                                                                          Is Modifierfalse
                                                                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                          Summaryfalse
                                                                                                                                          Fixed Valuereference
                                                                                                                                          290. Composition.event:procedure.detail.extension:detailext.extension:reference.value[x]
                                                                                                                                          Definition

                                                                                                                                          A reference to a resource the provides exact details about the information being referenced.

                                                                                                                                          ShortReference to a resource (by instance)
                                                                                                                                          Comments

                                                                                                                                          Composition.event.detail maps to R4 Composition.event.detail. So is mapped as Equivalent.

                                                                                                                                          Control0..1
                                                                                                                                          TypeReference(IM Imaging Procedure)
                                                                                                                                          [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()))
                                                                                                                                          292. Composition.event:procedure.detail.extension:detailext.url
                                                                                                                                          Definition

                                                                                                                                          Source of the definition for the extension code - a logical name or a URL.

                                                                                                                                          Shortidentifies the meaning of the extension
                                                                                                                                          Comments

                                                                                                                                          The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                                                                                                                          Control1..1
                                                                                                                                          Typeuri
                                                                                                                                          Is Modifierfalse
                                                                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                          Summaryfalse
                                                                                                                                          Fixed Valuehttp://hl7.org/fhir/5.0/StructureDefinition/extension-Composition.event.detail
                                                                                                                                          294. Composition.event:procedure.detail.extension:detailext.value[x]
                                                                                                                                          Definition

                                                                                                                                          Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                                                                                                                          ShortValue of extension
                                                                                                                                          Control0..0
                                                                                                                                          TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                                                                                                                                          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()))
                                                                                                                                          296. Composition.event:procedure.detail.reference
                                                                                                                                          Definition

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

                                                                                                                                          ShortLiteral reference, Relative, internal or absolute URL
                                                                                                                                          Comments

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

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

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

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

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

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

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

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

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

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

                                                                                                                                          ShortLogical reference, when literal reference is not known
                                                                                                                                          Comments

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

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

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

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

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

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

                                                                                                                                          ShortText alternative for the resource
                                                                                                                                          Comments

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

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

                                                                                                                                          The root of the sections that make up the composition.

                                                                                                                                          ShortComposition is broken into sections
                                                                                                                                          Control8..*
                                                                                                                                          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()))
                                                                                                                                          eu-imaging-composition-1: When a section is empty, the emptyReason extension SHALL be present. (entry.empty() and emptyReason.exists())
                                                                                                                                          SlicingThis element introduces a set of slices on Composition.section. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                          • value @ code
                                                                                                                                          • 306. 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
                                                                                                                                            308. 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())
                                                                                                                                            310. 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())
                                                                                                                                            312. 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()))
                                                                                                                                            314. 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.

                                                                                                                                            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.

                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                            316. 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()))
                                                                                                                                            318. 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()))
                                                                                                                                            320. 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()))
                                                                                                                                            322. 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()))
                                                                                                                                            324. 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()))
                                                                                                                                            326. 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()))
                                                                                                                                            328. 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 Reasons a section in an imaging report is empty.
                                                                                                                                            (preferred to http://hl7.eu/fhir/imaging-r4/ValueSet/ImSectionEmptyReason)
                                                                                                                                            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()))
                                                                                                                                            330. 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()))
                                                                                                                                            332. Composition.section:imagingstudy
                                                                                                                                            Slice Nameimagingstudy
                                                                                                                                            Definition

                                                                                                                                            This section holds information related to the imaging studies covered by this report.

                                                                                                                                            ShortImaging Study
                                                                                                                                            Control1..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()))
                                                                                                                                            334. Composition.section:imagingstudy.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
                                                                                                                                            336. Composition.section:imagingstudy.extension
                                                                                                                                            Definition

                                                                                                                                            An Extension

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

                                                                                                                                              Additional notes that apply to this resource or element.

                                                                                                                                              ShortAdditional notes that apply to this resource or element.
                                                                                                                                              Comments

                                                                                                                                              This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                                                                                                                              Control0..*
                                                                                                                                              TypeExtension(Note) (Extension Type: Annotation)
                                                                                                                                              Is Modifierfalse
                                                                                                                                              Summaryfalse
                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                              340. Composition.section:imagingstudy.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())
                                                                                                                                              342. Composition.section:imagingstudy.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()))
                                                                                                                                              344. Composition.section:imagingstudy.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://loinc.org",
                                                                                                                                                  "code" : "18726-0"
                                                                                                                                                }]
                                                                                                                                              }
                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                              346. Composition.section:imagingstudy.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()))
                                                                                                                                              348. Composition.section:imagingstudy.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()))
                                                                                                                                              350. Composition.section:imagingstudy.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()))
                                                                                                                                              352. Composition.section:imagingstudy.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()))
                                                                                                                                              354. Composition.section:imagingstudy.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()))
                                                                                                                                              356. Composition.section:imagingstudy.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.

                                                                                                                                              Control1..*
                                                                                                                                              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
                                                                                                                                              • 358. Composition.section:imagingstudy.entry:imagingstudy
                                                                                                                                                Slice Nameimagingstudy
                                                                                                                                                Definition

                                                                                                                                                This entry holds a reference to the Imaging Study instance that is associated with this Composition.

                                                                                                                                                ShortImaging Study Reference
                                                                                                                                                Comments

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

                                                                                                                                                Control1..*
                                                                                                                                                This element is affected by the following invariants: cmp-2
                                                                                                                                                TypeReference(IM Imaging Study)
                                                                                                                                                Is Modifierfalse
                                                                                                                                                Summaryfalse
                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                360. Composition.section:imagingstudy.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 Reasons a section in an imaging report is empty.
                                                                                                                                                (preferred to http://hl7.eu/fhir/imaging-r4/ValueSet/ImSectionEmptyReason)
                                                                                                                                                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()))
                                                                                                                                                362. Composition.section:imagingstudy.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()))
                                                                                                                                                364. Composition.section:order
                                                                                                                                                Slice Nameorder
                                                                                                                                                Definition

                                                                                                                                                This section holds information related to the order for the imaging study.

                                                                                                                                                ShortOrder
                                                                                                                                                Control1..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()))
                                                                                                                                                366. Composition.section:order.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
                                                                                                                                                368. Composition.section:order.extension
                                                                                                                                                Definition

                                                                                                                                                An Extension

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

                                                                                                                                                  Additional notes that apply to this resource or element.

                                                                                                                                                  ShortAdditional notes that apply to this resource or element.
                                                                                                                                                  Comments

                                                                                                                                                  This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                                                                                                                                  Control0..*
                                                                                                                                                  TypeExtension(Note) (Extension Type: Annotation)
                                                                                                                                                  Is Modifierfalse
                                                                                                                                                  Summaryfalse
                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                  372. Composition.section:order.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())
                                                                                                                                                  374. Composition.section:order.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()))
                                                                                                                                                  376. Composition.section:order.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://loinc.org",
                                                                                                                                                      "code" : "55115-0",
                                                                                                                                                      "display" : "Requested imaging studies information Document"
                                                                                                                                                    }]
                                                                                                                                                  }
                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                  378. Composition.section:order.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()))
                                                                                                                                                  380. Composition.section:order.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()))
                                                                                                                                                  382. Composition.section:order.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()))
                                                                                                                                                  384. Composition.section:order.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()))
                                                                                                                                                  386. Composition.section:order.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()))
                                                                                                                                                  388. Composition.section:order.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()))
                                                                                                                                                  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
                                                                                                                                                  • 390. Composition.section:order.entry:order
                                                                                                                                                    Slice Nameorder
                                                                                                                                                    Definition

                                                                                                                                                    This entry holds a reference to the order for the Imaging Study and report.

                                                                                                                                                    ShortOrder reference
                                                                                                                                                    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(IM Imaging Order)
                                                                                                                                                    Is Modifierfalse
                                                                                                                                                    Summaryfalse
                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    392. Composition.section:order.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 Reasons a section in an imaging report is empty.
                                                                                                                                                    (preferred to http://hl7.eu/fhir/imaging-r4/ValueSet/ImSectionEmptyReason)
                                                                                                                                                    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()))
                                                                                                                                                    394. Composition.section:order.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()))
                                                                                                                                                    396. Composition.section:history
                                                                                                                                                    Slice Namehistory
                                                                                                                                                    Definition

                                                                                                                                                    The root of the sections that make up the composition.

                                                                                                                                                    ShortHistory
                                                                                                                                                    Control1..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()))
                                                                                                                                                    398. Composition.section:history.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
                                                                                                                                                    400. Composition.section:history.extension
                                                                                                                                                    Definition

                                                                                                                                                    An Extension

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

                                                                                                                                                      Additional notes that apply to this resource or element.

                                                                                                                                                      ShortAdditional notes that apply to this resource or element.
                                                                                                                                                      Comments

                                                                                                                                                      This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                                                                                                                                      Control0..*
                                                                                                                                                      TypeExtension(Note) (Extension Type: Annotation)
                                                                                                                                                      Is Modifierfalse
                                                                                                                                                      Summaryfalse
                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                      404. Composition.section:history.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())
                                                                                                                                                      406. Composition.section:history.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()))
                                                                                                                                                      408. Composition.section:history.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://loinc.org",
                                                                                                                                                          "code" : "11329-0",
                                                                                                                                                          "display" : "History general Narrative - Reported"
                                                                                                                                                        }]
                                                                                                                                                      }
                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                      410. Composition.section:history.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()))
                                                                                                                                                      412. Composition.section:history.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()))
                                                                                                                                                      414. Composition.section:history.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()))
                                                                                                                                                      416. Composition.section:history.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()))
                                                                                                                                                      418. Composition.section:history.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()))
                                                                                                                                                      420. Composition.section:history.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()))
                                                                                                                                                      422. Composition.section:history.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 Reasons a section in an imaging report is empty.
                                                                                                                                                      (preferred to http://hl7.eu/fhir/imaging-r4/ValueSet/ImSectionEmptyReason)
                                                                                                                                                      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()))
                                                                                                                                                      424. Composition.section:history.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()))
                                                                                                                                                      426. Composition.section:procedure
                                                                                                                                                      Slice Nameprocedure
                                                                                                                                                      Definition

                                                                                                                                                      The root of the sections that make up the composition.

                                                                                                                                                      ShortProcedure
                                                                                                                                                      Control1..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()))
                                                                                                                                                      428. Composition.section:procedure.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
                                                                                                                                                      430. Composition.section:procedure.extension
                                                                                                                                                      Definition

                                                                                                                                                      An Extension

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

                                                                                                                                                        Additional notes that apply to this resource or element.

                                                                                                                                                        ShortAdditional notes that apply to this resource or element.
                                                                                                                                                        Comments

                                                                                                                                                        This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                                                                                                                                        Control0..*
                                                                                                                                                        TypeExtension(Note) (Extension Type: Annotation)
                                                                                                                                                        Is Modifierfalse
                                                                                                                                                        Summaryfalse
                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                        434. Composition.section:procedure.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())
                                                                                                                                                        436. Composition.section:procedure.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()))
                                                                                                                                                        438. Composition.section:procedure.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://loinc.org",
                                                                                                                                                            "code" : "55111-9",
                                                                                                                                                            "display" : "Current imaging procedure descriptions Document"
                                                                                                                                                          }]
                                                                                                                                                        }
                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                        440. Composition.section:procedure.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()))
                                                                                                                                                        442. Composition.section:procedure.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()))
                                                                                                                                                        444. Composition.section:procedure.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()))
                                                                                                                                                        446. Composition.section:procedure.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()))
                                                                                                                                                        448. Composition.section:procedure.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()))
                                                                                                                                                        450. Composition.section:procedure.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()))
                                                                                                                                                        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
                                                                                                                                                        • 452. Composition.section:procedure.entry:procedure
                                                                                                                                                          Slice Nameprocedure
                                                                                                                                                          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(IM Imaging Procedure)
                                                                                                                                                          Is Modifierfalse
                                                                                                                                                          Summaryfalse
                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                          454. Composition.section:procedure.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 Reasons a section in an imaging report is empty.
                                                                                                                                                          (preferred to http://hl7.eu/fhir/imaging-r4/ValueSet/ImSectionEmptyReason)
                                                                                                                                                          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()))
                                                                                                                                                          456. Composition.section:procedure.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()))
                                                                                                                                                          458. Composition.section:comparison
                                                                                                                                                          Slice Namecomparison
                                                                                                                                                          Definition

                                                                                                                                                          The root of the sections that make up the composition.

                                                                                                                                                          ShortHistory
                                                                                                                                                          Control1..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()))
                                                                                                                                                          460. Composition.section:comparison.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
                                                                                                                                                          462. Composition.section:comparison.extension
                                                                                                                                                          Definition

                                                                                                                                                          An Extension

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

                                                                                                                                                            Additional notes that apply to this resource or element.

                                                                                                                                                            ShortAdditional notes that apply to this resource or element.
                                                                                                                                                            Comments

                                                                                                                                                            This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                                                                                                                                            Control0..*
                                                                                                                                                            TypeExtension(Note) (Extension Type: Annotation)
                                                                                                                                                            Is Modifierfalse
                                                                                                                                                            Summaryfalse
                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                            466. Composition.section:comparison.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())
                                                                                                                                                            468. Composition.section:comparison.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()))
                                                                                                                                                            470. Composition.section:comparison.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://loinc.org",
                                                                                                                                                                "code" : "18834-2",
                                                                                                                                                                "display" : "Radiology Comparison study (narrative)"
                                                                                                                                                              }]
                                                                                                                                                            }
                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                            472. Composition.section:comparison.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()))
                                                                                                                                                            474. Composition.section:comparison.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()))
                                                                                                                                                            476. Composition.section:comparison.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()))
                                                                                                                                                            478. Composition.section:comparison.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()))
                                                                                                                                                            480. Composition.section:comparison.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()))
                                                                                                                                                            482. Composition.section:comparison.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()))
                                                                                                                                                            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
                                                                                                                                                            • 484. Composition.section:comparison.entry:comparedstudy
                                                                                                                                                              Slice Namecomparedstudy
                                                                                                                                                              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(IM Imaging Study, Imaging Selection profile for R4)
                                                                                                                                                              Is Modifierfalse
                                                                                                                                                              Summaryfalse
                                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                              486. Composition.section:comparison.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 Reasons a section in an imaging report is empty.
                                                                                                                                                              (preferred to http://hl7.eu/fhir/imaging-r4/ValueSet/ImSectionEmptyReason)
                                                                                                                                                              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()))
                                                                                                                                                              488. Composition.section:comparison.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()))
                                                                                                                                                              490. Composition.section:findings
                                                                                                                                                              Slice Namefindings
                                                                                                                                                              Definition

                                                                                                                                                              The root of the sections that make up the composition.

                                                                                                                                                              ShortFindings
                                                                                                                                                              Control1..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()))
                                                                                                                                                              492. Composition.section:findings.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
                                                                                                                                                              494. Composition.section:findings.extension
                                                                                                                                                              Definition

                                                                                                                                                              An Extension

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

                                                                                                                                                                Additional notes that apply to this resource or element.

                                                                                                                                                                ShortAdditional notes that apply to this resource or element.
                                                                                                                                                                Comments

                                                                                                                                                                This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                                                                                                                                                Control0..*
                                                                                                                                                                TypeExtension(Note) (Extension Type: Annotation)
                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                Summaryfalse
                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                                498. Composition.section:findings.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())
                                                                                                                                                                500. Composition.section:findings.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()))
                                                                                                                                                                502. Composition.section:findings.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://loinc.org",
                                                                                                                                                                    "code" : "59776-5",
                                                                                                                                                                    "display" : "Findings"
                                                                                                                                                                  }]
                                                                                                                                                                }
                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                504. Composition.section:findings.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()))
                                                                                                                                                                506. Composition.section:findings.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()))
                                                                                                                                                                508. Composition.section:findings.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()))
                                                                                                                                                                510. Composition.section:findings.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()))
                                                                                                                                                                512. Composition.section:findings.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()))
                                                                                                                                                                514. Composition.section:findings.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()))
                                                                                                                                                                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
                                                                                                                                                                • 516. Composition.section:findings.entry:finding
                                                                                                                                                                  Slice Namefinding
                                                                                                                                                                  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(Finding)
                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                  Summaryfalse
                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                  518. Composition.section:findings.entry:keyimage
                                                                                                                                                                  Slice Namekeyimage
                                                                                                                                                                  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(Imaging Key Image Document Reference, Key images represented as an ImagingSelection for R4)
                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                  Summaryfalse
                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                  520. Composition.section:findings.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 Reasons a section in an imaging report is empty.
                                                                                                                                                                  (preferred to http://hl7.eu/fhir/imaging-r4/ValueSet/ImSectionEmptyReason)
                                                                                                                                                                  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()))
                                                                                                                                                                  522. Composition.section:findings.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()))
                                                                                                                                                                  524. Composition.section:impression
                                                                                                                                                                  Slice Nameimpression
                                                                                                                                                                  Definition

                                                                                                                                                                  The root of the sections that make up the composition.

                                                                                                                                                                  ShortImpressions
                                                                                                                                                                  Control1..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()))
                                                                                                                                                                  526. Composition.section:impression.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
                                                                                                                                                                  528. Composition.section:impression.extension
                                                                                                                                                                  Definition

                                                                                                                                                                  An Extension

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

                                                                                                                                                                    Additional notes that apply to this resource or element.

                                                                                                                                                                    ShortAdditional notes that apply to this resource or element.
                                                                                                                                                                    Comments

                                                                                                                                                                    This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                                                                                                                                                    Control0..*
                                                                                                                                                                    TypeExtension(Note) (Extension Type: Annotation)
                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                    Summaryfalse
                                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                                    532. Composition.section:impression.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())
                                                                                                                                                                    534. Composition.section:impression.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()))
                                                                                                                                                                    536. Composition.section:impression.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://loinc.org",
                                                                                                                                                                        "code" : "19005-8",
                                                                                                                                                                        "display" : "Radiology Imaging study [Impression] (narrative)"
                                                                                                                                                                      }]
                                                                                                                                                                    }
                                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                    538. Composition.section:impression.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()))
                                                                                                                                                                    540. Composition.section:impression.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()))
                                                                                                                                                                    542. Composition.section:impression.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()))
                                                                                                                                                                    544. Composition.section:impression.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()))
                                                                                                                                                                    546. Composition.section:impression.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()))
                                                                                                                                                                    548. Composition.section:impression.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()))
                                                                                                                                                                    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
                                                                                                                                                                    • 550. Composition.section:impression.entry:finding
                                                                                                                                                                      Slice Namefinding
                                                                                                                                                                      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(Finding)
                                                                                                                                                                      Is Modifierfalse
                                                                                                                                                                      Summaryfalse
                                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                      552. Composition.section:impression.entry:impression
                                                                                                                                                                      Slice Nameimpression
                                                                                                                                                                      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(EU Condition)
                                                                                                                                                                      Is Modifierfalse
                                                                                                                                                                      Summaryfalse
                                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                      554. Composition.section:impression.entry:keyimage
                                                                                                                                                                      Slice Namekeyimage
                                                                                                                                                                      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(Imaging Key Image Document Reference, Key images represented as an ImagingSelection for R4)
                                                                                                                                                                      Is Modifierfalse
                                                                                                                                                                      Summaryfalse
                                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                      556. Composition.section:impression.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 Reasons a section in an imaging report is empty.
                                                                                                                                                                      (preferred to http://hl7.eu/fhir/imaging-r4/ValueSet/ImSectionEmptyReason)
                                                                                                                                                                      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()))
                                                                                                                                                                      558. Composition.section:impression.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()))
                                                                                                                                                                      560. Composition.section:recommendation
                                                                                                                                                                      Slice Namerecommendation
                                                                                                                                                                      Definition

                                                                                                                                                                      The root of the sections that make up the composition.

                                                                                                                                                                      ShortRecommendations
                                                                                                                                                                      Control1..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()))
                                                                                                                                                                      562. Composition.section:recommendation.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
                                                                                                                                                                      564. Composition.section:recommendation.extension
                                                                                                                                                                      Definition

                                                                                                                                                                      An Extension

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

                                                                                                                                                                        Additional notes that apply to this resource or element.

                                                                                                                                                                        ShortAdditional notes that apply to this resource or element.
                                                                                                                                                                        Comments

                                                                                                                                                                        This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                                                                                                                                                        Control0..*
                                                                                                                                                                        TypeExtension(Note) (Extension Type: Annotation)
                                                                                                                                                                        Is Modifierfalse
                                                                                                                                                                        Summaryfalse
                                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                                        568. Composition.section:recommendation.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())
                                                                                                                                                                        570. Composition.section:recommendation.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()))
                                                                                                                                                                        572. Composition.section:recommendation.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://loinc.org",
                                                                                                                                                                            "code" : "18783-1",
                                                                                                                                                                            "display" : "Radiology Study recommendation (narrative)"
                                                                                                                                                                          }]
                                                                                                                                                                        }
                                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                        574. Composition.section:recommendation.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()))
                                                                                                                                                                        576. Composition.section:recommendation.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()))
                                                                                                                                                                        578. Composition.section:recommendation.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()))
                                                                                                                                                                        580. Composition.section:recommendation.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()))
                                                                                                                                                                        582. Composition.section:recommendation.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()))
                                                                                                                                                                        584. Composition.section:recommendation.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()))
                                                                                                                                                                        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
                                                                                                                                                                        • 586. Composition.section:recommendation.entry:careplan
                                                                                                                                                                          Slice Namecareplan
                                                                                                                                                                          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(EU CarePlan)
                                                                                                                                                                          Is Modifierfalse
                                                                                                                                                                          Summaryfalse
                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                          588. Composition.section:recommendation.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 Reasons a section in an imaging report is empty.
                                                                                                                                                                          (preferred to http://hl7.eu/fhir/imaging-r4/ValueSet/ImSectionEmptyReason)
                                                                                                                                                                          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()))
                                                                                                                                                                          590. Composition.section:recommendation.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()))
                                                                                                                                                                          592. Composition.section:communication
                                                                                                                                                                          Slice Namecommunication
                                                                                                                                                                          Definition

                                                                                                                                                                          The root of the sections that make up the composition.

                                                                                                                                                                          ShortCommunications
                                                                                                                                                                          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()))
                                                                                                                                                                          594. Composition.section:communication.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
                                                                                                                                                                          596. Composition.section:communication.extension
                                                                                                                                                                          Definition

                                                                                                                                                                          An Extension

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

                                                                                                                                                                            Additional notes that apply to this resource or element.

                                                                                                                                                                            ShortAdditional notes that apply to this resource or element.
                                                                                                                                                                            Comments

                                                                                                                                                                            This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element

                                                                                                                                                                            Control0..*
                                                                                                                                                                            TypeExtension(Note) (Extension Type: Annotation)
                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                            Summaryfalse
                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                                            600. Composition.section:communication.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())
                                                                                                                                                                            602. Composition.section:communication.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()))
                                                                                                                                                                            604. Composition.section:communication.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://loinc.org",
                                                                                                                                                                                "code" : "18783-1",
                                                                                                                                                                                "display" : "Radiology Study recommendation (narrative)"
                                                                                                                                                                              }]
                                                                                                                                                                            }
                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                            606. Composition.section:communication.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()))
                                                                                                                                                                            608. Composition.section:communication.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()))
                                                                                                                                                                            610. Composition.section:communication.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()))
                                                                                                                                                                            612. Composition.section:communication.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()))
                                                                                                                                                                            614. Composition.section:communication.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()))
                                                                                                                                                                            616. Composition.section:communication.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()))
                                                                                                                                                                            618. Composition.section:communication.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 Reasons a section in an imaging report is empty.
                                                                                                                                                                            (preferred to http://hl7.eu/fhir/imaging-r4/ValueSet/ImSectionEmptyReason)
                                                                                                                                                                            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()))
                                                                                                                                                                            620. Composition.section:communication.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()))