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: Report_EuSubstance - Detailed Descriptions

Draft as of 2025-07-02

Definitions for the Report-EuSubstance resource profile.

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

0. Substance
Definition

A homogeneous material with a definite composition.

ShortA homogeneous material with a definite composition
Control0..*
Is Modifierfalse
Must Supportfalse
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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(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. Substance.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 its 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 its meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Substance.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

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..*
This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
TypeResource
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
6. Substance.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 managable, 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
Must Supportfalse
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
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. Substance.identifier
Definition

Unique identifier for the substance. For an instance, an identifier associated with the package/container (usually a label affixed directly).

ShortUnique identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Is Modifierfalse
Must Supportfalse
Obligations
    ObligationsActorDocumentation
    SHALL:populate-if-knownImaging study report provider

    EHDSSubstance.identifier

    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    10. Substance.instance
    Definition

    A boolean to indicate if this an instance of a substance or a kind of one (a definition).

    ShortIs this an instance of a substance or a kind of one
    Control1..1
    Typeboolean
    Is Modifiertrue because Not known why this is labelled a modifier
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    12. Substance.status
    Definition

    A code to indicate if the substance is actively used.

    Shortactive | inactive | entered-in-error
    Control0..1
    BindingThe codes SHALL be taken from FHIRSubstanceStatushttp://hl7.org/fhir/ValueSet/substance-status|5.0.0
    (required to http://hl7.org/fhir/ValueSet/substance-status|5.0.0)

    A code to indicate if the substance is actively used.

    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
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. Substance.code
    Definition

    A code (or set of codes) that identify this substance.

    ShortWhat substance this is
    Comments

    This could be a reference to an externally defined code. It could also be a locally assigned code (e.g. a formulary), optionally with translations to the standard drug codes.

    Control1..1
    BindingFor example codes, see SubstanceCodehttp://hl7.org/fhir/ValueSet/substance-code
    (example to http://hl7.org/fhir/ValueSet/substance-code)

    Substance codes.

    TypeCodeableReference(SubstanceDefinition)
    Is Modifierfalse
    Must Supportfalse
    Obligations
      ObligationsActorDocumentation
      SHALL:populate-if-knownImaging study report provider

      EHDSSubstance.code

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

      A description of the substance - its appearance, handling requirements, and other usage notes.

      ShortTextual description of the substance, comments
      Control0..1
      Typemarkdown
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Obligations
        ObligationsActorDocumentation
        SHALL:populate-if-knownImaging study report provider

        EHDSSubstance.description

        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        18. Substance.expiry
        Definition

        When the substance is no longer valid to use. For some substances, a single arbitrary date is used for expiry.

        ShortWhen no longer valid to use
        Control0..1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Obligations
          ObligationsActorDocumentation
          SHALL:populate-if-knownImaging study report provider

          EHDSSubstance.expiry

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

          The amount of the substance.

          ShortAmount of substance in the package
          Control0..1
          TypeQuantity(SimpleQuantity)
          Is Modifierfalse
          Must Supportfalse
          Obligations
            ObligationsActorDocumentation
            SHALL:populate-if-knownImaging study report provider

            EHDSSubstance.quantity

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

            A substance can be composed of other substances.

            ShortComposition information about the substance
            Control0..*
            TypeBackboneElement
            Is Modifierfalse
            Must Supportfalse
            Obligations
              ObligationsActorDocumentation
              SHALL:populate-if-knownImaging study report provider

              EHDSSubstance.ingredients

              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              24. Substance.ingredient.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 managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

              ShortExtensions that cannot be ignored even if unrecognized
              Comments

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

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

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

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

              The amount of the ingredient in the substance - a concentration ratio.

              ShortOptional amount (concentration)
              Control0..1
              TypeRatio
              Is Modifierfalse
              Must Supportfalse
              Obligations
                ObligationsActorDocumentation
                SHALL:populate-if-knownImaging study report provider

                EHDSSubstance.ingredients.quantity

                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                28. Substance.ingredient.substance[x]
                Definition

                Another substance that is a component of this substance.

                ShortA component of the substance
                Control1..1
                BindingFor example codes, see SubstanceCodehttp://hl7.org/fhir/ValueSet/substance-code
                (example to http://hl7.org/fhir/ValueSet/substance-code)

                Substance Ingredient codes.

                TypeChoice of: CodeableConcept, Reference(Substance)
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Is Modifierfalse
                Must Supportfalse
                Summarytrue
                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 Substance.ingredient.substance[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • type @ $this
                • 30. Substance.ingredient.substance[x]:substanceReference
                  Slice NamesubstanceReference
                  Definition

                  Another substance that is a component of this substance.

                  ShortA component of the substance
                  Control01..1
                  TypeReference(Substance), CodeableConcept
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Must Supportfalse
                  Obligations
                    ObligationsActorDocumentation
                    SHALL:populate-if-knownImaging study report provider

                    EHDSSubstance.ingredients.substance

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

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

                    0. Substance
                    2. Substance.identifier
                    NoteThis is a business identifier, not a resource identifier (see discussion)
                    Obligations
                      ObligationsActorDocumentation
                      SHALL:populate-if-knownImaging study report provider

                      EHDSSubstance.identifier

                      4. Substance.code
                      Obligations
                        ObligationsActorDocumentation
                        SHALL:populate-if-knownImaging study report provider

                        EHDSSubstance.code

                        6. Substance.description
                        Obligations
                          ObligationsActorDocumentation
                          SHALL:populate-if-knownImaging study report provider

                          EHDSSubstance.description

                          8. Substance.expiry
                          Obligations
                            ObligationsActorDocumentation
                            SHALL:populate-if-knownImaging study report provider

                            EHDSSubstance.expiry

                            10. Substance.quantity
                            Obligations
                              ObligationsActorDocumentation
                              SHALL:populate-if-knownImaging study report provider

                              EHDSSubstance.quantity

                              12. Substance.ingredient
                              Obligations
                                ObligationsActorDocumentation
                                SHALL:populate-if-knownImaging study report provider

                                EHDSSubstance.ingredients

                                14. Substance.ingredient.quantity
                                Obligations
                                  ObligationsActorDocumentation
                                  SHALL:populate-if-knownImaging study report provider

                                  EHDSSubstance.ingredients.quantity

                                  16. Substance.ingredient.substance[x]
                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                  SlicingThis element introduces a set of slices on Substance.ingredient.substance[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • type @ $this
                                  • 18. Substance.ingredient.substance[x]:substanceReference
                                    Slice NamesubstanceReference
                                    Control0..1
                                    TypeReference(Substance)
                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                    Obligations
                                      ObligationsActorDocumentation
                                      SHALL:populate-if-knownImaging study report provider

                                      EHDSSubstance.ingredients.substance

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

                                      0. Substance
                                      Definition

                                      A homogeneous material with a definite composition.

                                      ShortA homogeneous material with a definite composition
                                      Control0..*
                                      Is Modifierfalse
                                      Must Supportfalse
                                      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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(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. Substance.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

                                      Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

                                      Control0..1
                                      Typeid
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summarytrue
                                      4. Substance.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
                                      Must Supportfalse
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      6. Substance.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 its 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 its meaning or interpretation
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supportfalse
                                      Summarytrue
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      8. Substance.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 SHALL be taken from AllLanguages
                                      (required to http://hl7.org/fhir/ValueSet/all-languages|5.0.0)

                                      IETF language tag for a human language

                                      Typecode
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supportfalse
                                      Summaryfalse
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      10. Substance.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 a 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
                                      This element is affected by the following invariants: dom-6
                                      TypeNarrative
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Alternate Namesnarrative, html, xhtml, display
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      12. Substance.contained
                                      Definition

                                      These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

                                      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..*
                                      This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
                                      TypeResource
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Alternate Namesinline resources, anonymous resources, contained resources
                                      14. Substance.extension
                                      Definition

                                      May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, 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
                                      Must Supportfalse
                                      Summaryfalse
                                      Alternate Namesextensions, user content
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                      16. Substance.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 managable, 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
                                      Must Supportfalse
                                      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
                                      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. Substance.identifier
                                      Definition

                                      Unique identifier for the substance. For an instance, an identifier associated with the package/container (usually a label affixed directly).

                                      ShortUnique identifier
                                      NoteThis is a business identifier, not a resource identifier (see discussion)
                                      Control0..*
                                      TypeIdentifier
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Obligations
                                        ObligationsActorDocumentation
                                        SHALL:populate-if-knownImaging study report provider

                                        EHDSSubstance.identifier

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

                                        A boolean to indicate if this an instance of a substance or a kind of one (a definition).

                                        ShortIs this an instance of a substance or a kind of one
                                        Control1..1
                                        Typeboolean
                                        Is Modifiertrue because Not known why this is labelled a modifier
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supportfalse
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        22. Substance.status
                                        Definition

                                        A code to indicate if the substance is actively used.

                                        Shortactive | inactive | entered-in-error
                                        Control0..1
                                        BindingThe codes SHALL be taken from FHIRSubstanceStatus
                                        (required to http://hl7.org/fhir/ValueSet/substance-status|5.0.0)

                                        A code to indicate if the substance is actively used.

                                        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
                                        Must Supportfalse
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        24. Substance.category
                                        Definition

                                        A code that classifies the general type of substance. This is used for searching, sorting and display purposes.

                                        ShortWhat class/type of substance this is
                                        Comments

                                        The level of granularity is defined by the category concepts in the value set. More fine-grained filtering can be performed using the metadata and/or terminology hierarchy in Substance.code.

                                        Control0..*
                                        BindingUnless not suitable, these codes SHALL be taken from SubstanceCategoryCodes
                                        (extensible to http://hl7.org/fhir/ValueSet/substance-category)

                                        Category or classification of substance.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        26. Substance.code
                                        Definition

                                        A code (or set of codes) that identify this substance.

                                        ShortWhat substance this is
                                        Comments

                                        This could be a reference to an externally defined code. It could also be a locally assigned code (e.g. a formulary), optionally with translations to the standard drug codes.

                                        Control1..1
                                        BindingFor example codes, see SubstanceCode
                                        (example to http://hl7.org/fhir/ValueSet/substance-code)

                                        Substance codes.

                                        TypeCodeableReference(SubstanceDefinition)
                                        Is Modifierfalse
                                        Must Supportfalse
                                        Obligations
                                          ObligationsActorDocumentation
                                          SHALL:populate-if-knownImaging study report provider

                                          EHDSSubstance.code

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

                                          A description of the substance - its appearance, handling requirements, and other usage notes.

                                          ShortTextual description of the substance, comments
                                          Control0..1
                                          Typemarkdown
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supportfalse
                                          Obligations
                                            ObligationsActorDocumentation
                                            SHALL:populate-if-knownImaging study report provider

                                            EHDSSubstance.description

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

                                            When the substance is no longer valid to use. For some substances, a single arbitrary date is used for expiry.

                                            ShortWhen no longer valid to use
                                            Control0..1
                                            TypedateTime
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supportfalse
                                            Obligations
                                              ObligationsActorDocumentation
                                              SHALL:populate-if-knownImaging study report provider

                                              EHDSSubstance.expiry

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

                                              The amount of the substance.

                                              ShortAmount of substance in the package
                                              Control0..1
                                              TypeQuantity(SimpleQuantity)
                                              Is Modifierfalse
                                              Must Supportfalse
                                              Obligations
                                                ObligationsActorDocumentation
                                                SHALL:populate-if-knownImaging study report provider

                                                EHDSSubstance.quantity

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

                                                A substance can be composed of other substances.

                                                ShortComposition information about the substance
                                                Control0..*
                                                TypeBackboneElement
                                                Is Modifierfalse
                                                Must Supportfalse
                                                Obligations
                                                  ObligationsActorDocumentation
                                                  SHALL:populate-if-knownImaging study report provider

                                                  EHDSSubstance.ingredients

                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  36. Substance.ingredient.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
                                                  This element is affected by the following invariants: ele-1
                                                  Typestring
                                                  Is Modifierfalse
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  Summaryfalse
                                                  38. Substance.ingredient.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 managable, 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())
                                                  40. Substance.ingredient.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 managable, 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())
                                                  42. Substance.ingredient.quantity
                                                  Definition

                                                  The amount of the ingredient in the substance - a concentration ratio.

                                                  ShortOptional amount (concentration)
                                                  Control0..1
                                                  TypeRatio
                                                  Is Modifierfalse
                                                  Must Supportfalse
                                                  Obligations
                                                    ObligationsActorDocumentation
                                                    SHALL:populate-if-knownImaging study report provider

                                                    EHDSSubstance.ingredients.quantity

                                                    Summarytrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    44. Substance.ingredient.substance[x]
                                                    Definition

                                                    Another substance that is a component of this substance.

                                                    ShortA component of the substance
                                                    Control1..1
                                                    BindingFor example codes, see SubstanceCode
                                                    (example to http://hl7.org/fhir/ValueSet/substance-code)

                                                    Substance Ingredient codes.

                                                    TypeChoice of: CodeableConcept, Reference(Substance)
                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                    Is Modifierfalse
                                                    Must Supportfalse
                                                    Summarytrue
                                                    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 Substance.ingredient.substance[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • type @ $this
                                                    • 46. Substance.ingredient.substance[x]:substanceReference
                                                      Slice NamesubstanceReference
                                                      Definition

                                                      Another substance that is a component of this substance.

                                                      ShortA component of the substance
                                                      Control0..1
                                                      TypeReference(Substance)
                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                      Is Modifierfalse
                                                      Must Supportfalse
                                                      Obligations
                                                        ObligationsActorDocumentation
                                                        SHALL:populate-if-knownImaging study report provider

                                                        EHDSSubstance.ingredients.substance

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