HL7 Europe Patient Summary
1.0.0-alpha - qa-preview 150

HL7 Europe Patient Summary - Downloaded Version 1.0.0-alpha See the Directory of published versions

## Resource Profile: CompositionEuEps - Detailed Descriptions

Page standards status: Draft | Maturity Level: 1

Definitions for the composition-eu-eps resource profile.

- Key Elements Table
- Differential Elements Table
- Snapshot Elements Table

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

0. Composition
Definition | Patient Summary 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. 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.).
Short | Patient Summary 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.
Control | 0..*
Is Modifier | false
Impose Profile | This profile also requires that the instance also conform this additional profile: Composition (IPS)
Summary | false
Invariants | dom-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.
Short | A 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.
Control | 0..1
Type | uri
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. 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.
Short | Text 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.
Control | 0..1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. 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.
Short | ExtensionAdditional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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())
Slicing | This element introduces a set of slices on `Composition.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
8. Composition.extension:version
Slice Name | version
Definition | This cross-version extension represents Composition.version from http://hl7.org/fhir/StructureDefinition/Composition|5.0.0 for use in FHIR R4.
Short | Business version
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Cross-version Extension for R5.Composition.version for use in FHIR R4) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | 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()`) 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())
10. 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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
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 Names | extensions, user content
Invariants | 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())
12. Composition.identifier
Definition | A version-independent identifier for the Composition. This identifier stays constant as the composition is changed over time.
Short | PS business identifierVersion-independent identifier for the Composition
Comments | Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1
Type | Identifier
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. Composition.status
Definition | The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.
Short | PS statuspreliminary | 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.
Control | 1..1
Binding | The codes SHALL be taken from CompositionStatus http://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.
Type | code
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | true
Requirements | Need to be able to mark interim, amended, or withdrawn compositions or documents.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. Composition.type
Definition | Specifies that this composition refer to a Patient Summary 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.
Short | Kind of composition ("Patient Summary")Kind 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.
Control | 1..1
Binding | The codes SHOULD be taken from FHIRDocumentTypeCodes http://hl7.org/fhir/ValueSet/doc-typecodes|4.0.1 (preferred to `http://hl7.org/fhir/ValueSet/doc-typecodes|4.0.1` ) Type of a composition.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
Summary | true
Requirements | Key metadata element describing the composition, used in searching/filtering.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. Composition.subject
Definition | Who or what the composition is about. In general a 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). For the PS the subject is always the patient. 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).
Short | Who and/or what the composition is about
Comments | For clinical documents, this is usually the patient.
Control | 10..1
Type | Reference(Patient (EPS), Resource)
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | true
Requirements | Essential metadata for searching for the composition. Identifies who and/or what the composition/document is about.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. Composition.subject.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.
Short | Literal 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.
Control | 10..1 This element is affected by the following invariants: ref-1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. Composition.date
Definition | The composition editing time, when the composition was last logically changed by the author.
Short | PS dateComposition editing time
Comments | The Last Modified Date on the composition may be after the date of the document was attested without being changed.
Control | 1..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | true
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.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. Composition.author
Definition | Identifies who is responsible for the information in the Patient Summary, not necessarily who typed it in. Identifies who is responsible for the information in the composition, not necessarily who typed it in.
Short | Who and/or what authored the Patient SummaryWho and/or what authored the composition
Control | 1..*
Type | Reference(Practitioner (EU core), PractitionerRole (EU core), Device, Organization (EU core), Patient (EPS), RelatedPerson, Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | true
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. Composition.title
Definition | Official human-readable label for the composition. For this document should be "Patient Summary" or any equivalent translation Official human-readable label for the composition.
Short | Patient SummaryHuman 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.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. Composition.attester
Definition | A participant who has attested to the accuracy of the composition/document.
Short | Attests to accuracy of composition
Comments | Only list each attester once.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Identifies responsibility for the accuracy of the composition content.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. 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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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())
32. Composition.attester.mode
Definition | The type of attestation the authenticator offers.
Short | The type of attestationpersonal | professional | legal | official
Control | 1..1
Binding | The codes SHALL be taken from CompositionAttestationMode http://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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Indicates the level of authority of the attestation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. Composition.attester.time
Definition | When the composition was attested by the party.
Short | When the composition was attested
Control | 0..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. Composition.attester.party
Definition | Who attested the composition in the specified way.
Short | Who attested the composition
Control | 0..1
Type | Reference(Practitioner (EU core), PractitionerRole (EU core), Organization (EU core), Patient (EPS), RelatedPerson, Patient, RelatedPerson, Practitioner, PractitionerRole, Organization)
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Identifies who has taken on the responsibility for accuracy of the composition content.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. Composition.custodian
Definition | Identifies the organization that is responsible for ongoing maintenance of the Patient Summary, and ensures that it remains available for access by other parties. Identifies the organization or group who is responsible for ongoing maintenance of and access to the composition/document information.
Short | Custodian of the Patient SummaryOrganization 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.
Control | 0..1
Type | Reference(Organization (EU core), Organization)
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | true
Requirements | Identifies where to go to find the current version, where to report issues, etc.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. Composition.event
Definition | The clinical service, such as a colonoscopy or an appendectomy, being documented.
Short | The clinical service(s) being documented
Comments | The event needs to be consistent with the type element, though can provide further information if desired.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | true
Requirements | Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. 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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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())
44. 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.
Short | Code(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.
Control | 0..*
Binding | For example codes, see v3 Code System ActCode http://terminology.hl7.org/ValueSet/v3-ActCode (example to `http://terminology.hl7.org/ValueSet/v3-ActCode` ) This list of codes represents the main clinical acts being documented.
Type | CodeableConcept
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
46. 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.
Short | The period covered by the documentation
Control | 0..1
Type | Period
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
48. Composition.section
Definition | The root of the sections that make up the IPS composition. The root of the sections that make up the composition.
Short | Sections composing the IPSComposition is broken into sections
Control | 50..*
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | 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()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ips-comp-1: Either section.entry or emptyReason are present (`(entry.reference.exists() or 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())
Slicing | This element introduces a set of slices on `Composition.section`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ code
50. Composition.section.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.
Short | ExtensionAdditional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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())
Slicing | This 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
52. Composition.section.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`) 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())
54. 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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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())
56. 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.
Short | Label 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.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
58. Composition.section.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:handle | Consumer (IPS)
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
60. 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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 10..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
62. Composition.section.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
64. Composition.section:sectionProblems
Slice Name | sectionProblems
Definition | The EPS problem section lists and describes clinical problems or conditions currently being monitored for the patient. The root of the sections that make up the composition.
Short | EPS Problems SectionComposition is broken into sections
Control | 10..1*
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | 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()`) 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())
66. Composition.section:sectionProblems.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`) 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())
68. Composition.section:sectionProblems.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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())
70. Composition.section:sectionProblems.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.
Short | Label 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.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
72. Composition.section:sectionProblems.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "11450-4" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
74. Composition.section:sectionProblems.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 10..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
76. Composition.section:sectionProblems.entry
Definition | It lists and describes clinical problems or conditions currently being monitored for the patient. This entry shall be used to document that no information about problems is available, or that no relevant problems are known. A reference to the actual resource from which the narrative in the section is derived.
Short | Clinical problems or conditions currently being monitored for the patient.A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Condition, DocumentReference, Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
78. Composition.section:sectionProblems.entry:problem
Slice Name | problem
Definition | It lists and describes clinical problems or conditions currently being monitored for the patient. This entry shall be used to document that no information about problems is available, or that no relevant problems are known. A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Condition (EU core), Resource)
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:able-to-populate | Creator (IPS)
SHOULD:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
80. Composition.section:sectionProblems.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why 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.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1 (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
82. Composition.section:sectionProblems.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
84. Composition.section:sectionAllergies
Slice Name | sectionAllergies
Definition | This section documents the relevant allergies or intolerances for that patient, describing the kind of reaction - e.g. rash, anaphylaxis,.. - preferably the agents that cause it; and optionally the criticality and the certainty of the allergy. At a minimum, it should list currently active and any relevant historical allergies and adverse reactions. If no information about allergies is available, or if no allergies are known this should be clearly documented in the section. The root of the sections that make up the composition.
Short | EPS Allergies and Intolerances SectionComposition is broken into sections
Control | 10..1*
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | 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()`) 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())
86. Composition.section:sectionAllergies.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`) 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.section:sectionAllergies.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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())
90. Composition.section:sectionAllergies.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.
Short | Label 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.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
92. Composition.section:sectionAllergies.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "48765-2" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
94. Composition.section:sectionAllergies.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 10..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
96. Composition.section:sectionAllergies.entry
Definition | allergyOrIntolerance A reference to the actual resource from which the narrative in the section is derived.
Short | allergyOrIntoleranceA reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(AllergyIntolerance, DocumentReference, Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
98. Composition.section:sectionAllergies.entry:allergyOrIntolerance
Slice Name | allergyOrIntolerance
Definition | It lists the relevant allergies or intolerances for that patient, describing the kind of reaction - e.g. rash, anaphylaxis,.. - preferably the agents that cause it; and optionally the criticality and the certainty of the allergy. At a minimum, it should list currently active and any relevant historical allergies and adverse reactions. If no information about allergies is available, or if no allergies are known this should be clearly documented in the section. A reference to the actual resource from which the narrative in the section is derived.
Short | Relevant allergies or intolerances for that patient.A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(AllergyIntolerance (EU core), Resource)
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:able-to-populate | Creator (IPS)
SHOULD:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
100. Composition.section:sectionAllergies.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why 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.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1 (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
102. Composition.section:sectionAllergies.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
104. Composition.section:sectionMedications
Slice Name | sectionMedications
Definition | The medication summary section contains a description of the patient's medications relevant for the scope of the patient summary. The actual content could depend on the jurisdiction, it could report: * the currently active medications; * the current and past medications considered relevant by the authoring GP; * the patient prescriptions or dispensations automatically extracted by a regional or a national EHR. In those cases medications are documented in the Patient Summary as medication statements or medication requests. This section requires either an entry indicating the subject is known not to be on any relevant medication; either an entry indicating that no information is available about medications; or entries summarizing the subject's relevant medications. The root of the sections that make up the composition.
Short | EPS Medication Summary SectionComposition is broken into sections
Control | 10..1*
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | 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()`) 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())
106. Composition.section:sectionMedications.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`) 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())
108. Composition.section:sectionMedications.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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())
110. Composition.section:sectionMedications.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.
Short | Label 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.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
112. Composition.section:sectionMedications.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "10160-0" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
114. Composition.section:sectionMedications.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 10..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
116. Composition.section:sectionMedications.entry
Definition | medicationStatementOrRequest A reference to the actual resource from which the narrative in the section is derived.
Short | medicationStatementOrRequestA reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(MedicationStatement, MedicationRequest, MedicationAdministration, MedicationDispense, DocumentReference, Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
118. Composition.section:sectionMedications.entry:medicationStatementOrRequest
Slice Name | medicationStatementOrRequest
Definition | This list the medications relevant for the scope of the patient summary or it is used to indicate that the subject is known not to be on any relevant medication; either that no information is available about medications. A reference to the actual resource from which the narrative in the section is derived.
Short | Medications relevant for the scope of the patient summaryA reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Medication Statement (EPS), Resource)
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:able-to-populate | Creator (IPS)
SHOULD:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
120. Composition.section:sectionMedications.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why 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.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1 (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
122. Composition.section:sectionMedications.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
124. Composition.section:sectionImmunizations
Slice Name | sectionImmunizations
Definition | The Immunizations Section defines a patient's current immunization status and pertinent immunization history. The primary use case for the Immunization Section is to enable communication of a patient's immunization status. The section includes the current immunization status, and may contain the entire immunization history that is relevant to the period of time being summarized. The root of the sections that make up the composition.
Short | EPS Immunizations SectionComposition is broken into sections
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHOULD:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | 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()`) 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())
126. Composition.section:sectionImmunizations.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`) 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())
128. Composition.section:sectionImmunizations.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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.section:sectionImmunizations.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.
Short | Label 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.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
132. Composition.section:sectionImmunizations.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "11369-6" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
134. Composition.section:sectionImmunizations.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 10..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
136. Composition.section:sectionImmunizations.entry
Definition | It defines the patient's current immunization status and pertinent immunization history. The primary use case for the Immunization Section is to enable communication of a patient's immunization status. It may contain the entire immunization history that is relevant to the period of time being summarized. This entry shall be used to document that no information about immunizations is available, or that no immunizations are known. A reference to the actual resource from which the narrative in the section is derived.
Short | Patient's immunization status and pertinent history.A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Immunization, DocumentReference, Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
138. Composition.section:sectionImmunizations.entry:immunization
Slice Name | immunization
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Immunization (EU core), Resource)
Is Modifier | false
Obligations |
Obligations | Actor
SHOULD:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
140. Composition.section:sectionImmunizations.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
142. Composition.section:sectionResults
Slice Name | sectionResults
Definition | This section assembles relevant observation results collected on the patient or produced on in-vitro biologic specimens collected from the patient. Some of these results may be laboratory results, others may be anatomic pathology results, others, radiology results, and others, clinical results. The root of the sections that make up the composition.
Short | EPS Results SectionComposition is broken into sections
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHOULD:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | 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()`) 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())
144. Composition.section:sectionResults.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`) 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())
146. Composition.section:sectionResults.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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())
148. Composition.section:sectionResults.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.
Short | Label 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.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
150. Composition.section:sectionResults.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "30954-2" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
152. Composition.section:sectionResults.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 10..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
154. Composition.section:sectionResults.entry
Definition | EPS Results entry slice A reference to the actual resource from which the narrative in the section is derived.
Short | EPS Results entryA reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Observation, DiagnosticReport, DocumentReference, Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
156. Composition.section:sectionResults.entry:results-medicalTestResult
Slice Name | results-medicalTestResult
Definition | Results collected on the patient or produced on in-vitro biologic specimens. A reference to the actual resource from which the narrative in the section is derived.
Short | Medical test resultsA reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Observation: Medical Test Result (EU core), Resource)
Is Modifier | false
Obligations |
Obligations | Actor
SHOULD:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
158. Composition.section:sectionResults.entry:results-diagnosticReport
Slice Name | results-diagnosticReport
Definition | DiagnosticReport resource to represent diagnostic test and procedure reports in a patient summary A reference to the actual resource from which the narrative in the section is derived.
Short | EPS DiagnosticReportA reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(DiagnosticReport (EPS), Resource)
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
160. Composition.section:sectionResults.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
162. Composition.section:sectionProceduresHx
Slice Name | sectionProceduresHx
Definition | The History of Procedures Section contains a description of the patient past procedures that are pertinent to the scope of this document. Procedures may refer for example to:
      1. Invasive Diagnostic procedure:e.g. Cardiac catheterization; (the results of these procedure are documented in the results section)

      2. Therapeutic procedure: e.g. dialysis;

      3. Surgical procedure: e.g. appendectomy
The root of the sections that make up the composition.
Short | EPS History of Procedures SectionComposition is broken into sections
Control | 10..1*
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHOULD:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | 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()`) 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:sectionProceduresHx.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`) 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())
166. Composition.section:sectionProceduresHx.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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:sectionProceduresHx.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.
Short | Label 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.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
170. Composition.section:sectionProceduresHx.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "47519-4" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
172. Composition.section:sectionProceduresHx.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 10..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
174. Composition.section:sectionProceduresHx.entry
Definition | Slice on procedure A reference to the actual resource from which the narrative in the section is derived.
Short | Slice on procedureA reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Procedure, DocumentReference, Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
176. Composition.section:sectionProceduresHx.entry:procedure
Slice Name | procedure
Definition | It lists the patient past procedures that are pertinent to the scope of this document. Procedures may refer for example to:
      1. Invasive Diagnostic procedure:e.g. Cardiac catheterization; (the results of these procedure are documented in the results section)

      2. Therapeutic procedure: e.g. dialysis;

      3. Surgical procedure: e.g. appendectomy
A reference to the actual resource from which the narrative in the section is derived.
Short | Patient past procedures pertinent to the scope of this document.A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Procedure (EPS), Resource)
Is Modifier | false
Obligations |
Obligations | Actor
SHOULD:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
178. Composition.section:sectionProceduresHx.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
180. Composition.section:sectionMedicalDevices
Slice Name | sectionMedicalDevices
Definition | The medical devices section contains narrative text and coded entries describing the patient history of medical device use. The root of the sections that make up the composition.
Short | EPS Medical Devices SectionComposition is broken into sections
Control | 10..1*
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHOULD:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | 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()`) 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())
182. Composition.section:sectionMedicalDevices.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`) 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())
184. Composition.section:sectionMedicalDevices.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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())
186. Composition.section:sectionMedicalDevices.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.
Short | Label 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.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
188. Composition.section:sectionMedicalDevices.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "46264-8" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
190. Composition.section:sectionMedicalDevices.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 10..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
192. Composition.section:sectionMedicalDevices.entry
Definition | EPS Medical Devices entry slice A reference to the actual resource from which the narrative in the section is derived.
Short | EPS Medical Device entryA reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(DeviceUseStatement, DocumentReference, Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
194. Composition.section:sectionMedicalDevices.entry:deviceStatement
Slice Name | deviceStatement
Definition | It describes the patient history of medical device use. This entry shall be used to document that no information about medical device use is available, or that no relevant medical device use is known. A reference to the actual resource from which the narrative in the section is derived.
Short | Patient history of medical device useA reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(DeviceUseStatement (EPS), Resource)
Is Modifier | false
Obligations |
Obligations | Actor
SHOULD:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
196. Composition.section:sectionMedicalDevices.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
198. Composition.section:sectionAdvanceDirectives
Slice Name | sectionAdvanceDirectives
Definition | The advance directives section contains a narrative description of patient's advance directive. The root of the sections that make up the composition.
Short | EPS Advance Directives SectionComposition is broken into sections
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | 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()`) 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())
200. Composition.section:sectionAdvanceDirectives.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`) 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())
202. Composition.section:sectionAdvanceDirectives.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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())
204. Composition.section:sectionAdvanceDirectives.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.
Short | Label 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.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
206. Composition.section:sectionAdvanceDirectives.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "42348-3" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
208. Composition.section:sectionAdvanceDirectives.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 10..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
210. Composition.section:sectionAdvanceDirectives.entry
Definition | Advance directives A reference to the actual resource from which the narrative in the section is derived.
Short | Advance directivesA reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Consent, DocumentReference, Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
212. Composition.section:sectionAdvanceDirectives.entry:advanceDirectivesConsent
Slice Name | advanceDirectivesConsent
Definition | Contains a narrative description or a Consent entry with information about the patient's advance directive. A reference to the actual resource from which the narrative in the section is derived.
Short | Narrative description of the patient's advance directive.A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Consent (Advance Directives EPS), Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
214. Composition.section:sectionAdvanceDirectives.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
216. Composition.section:sectionAlert
Slice Name | sectionAlert
Definition | The alerts section flags potential concerns and/or dangers to/from the patient and may also include obstacles to care. The root of the sections that make up the composition.
Short | EPS Alerts SectionComposition is broken into sections
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | 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()`) 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())
218. Composition.section:sectionAlert.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`) 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:sectionAlert.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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())
222. Composition.section:sectionAlert.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.
Short | Label 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.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
224. Composition.section:sectionAlert.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "104605-1" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
226. Composition.section:sectionAlert.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 10..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
228. Composition.section:sectionAlert.entry
Definition | EPS Alerts entry slice A reference to the actual resource from which the narrative in the section is derived.
Short | EPS Alerts entryA reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Flag, DocumentReference, Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
230. Composition.section:sectionAlert.entry:flag
Slice Name | flag
Definition | Contains alert information to be communicated. May optionally reference other resources in IPS.lags A reference to the actual resource from which the narrative in the section is derived.
Short | Alert informationA reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Flag:Patient (EU core), Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
232. Composition.section:sectionAlert.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
234. Composition.section:sectionFunctionalStatus
Slice Name | sectionFunctionalStatus
Definition | The functional status section shall contain a narrative description of capability of the patient to perform acts of daily living, including possible needs of the patient to be continuously assessed by third parties. The invalidity status may in fact influence decisions about how to administer treatments. Profiles to express disabilities and functional assessments will be specified by future versions of this guide. The root of the sections that make up the composition.
Short | EPS Functional StatusComposition is broken into sections
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | 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()`) 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())
236. Composition.section:sectionFunctionalStatus.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`) 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())
238. Composition.section:sectionFunctionalStatus.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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())
240. Composition.section:sectionFunctionalStatus.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.
Short | Label 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.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
242. Composition.section:sectionFunctionalStatus.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "47420-5" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
244. Composition.section:sectionFunctionalStatus.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 10..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
246. Composition.section:sectionFunctionalStatus.entry
Definition | It describes capabilities of the patient to perform acts of daily living, including possible needs of the patient to be continuously assessed by third parties. The invalidity status may in fact influence decisions about how to administer treatments. Profiles to express disabilities and functional assessments will be specified by future versions of this guide. A reference to the actual resource from which the narrative in the section is derived.
Short | Optional entry used to represent disabilities and functional assessmentsA reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Condition, ClinicalImpression, DocumentReference, Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
248. Composition.section:sectionFunctionalStatus.entry:disability
Slice Name | disability
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | Optional slice used to represent disabilitiesA reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Condition (EU core), Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
250. Composition.section:sectionFunctionalStatus.entry:functionalAssessment
Slice Name | functionalAssessment
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | Optional slice used to represent functional assessmentsA reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(ClinicalImpression, Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
252. Composition.section:sectionFunctionalStatus.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
254. Composition.section:sectionPregnancyHx
Slice Name | sectionPregnancyHx
Definition | The history of pregnancy section shall contain information about whether the patient is currently pregnant or not. It may contain addition summarizing information about the outcome of earlier pregnancies The root of the sections that make up the composition.
Short | EPS History of Pregnancy SectionComposition is broken into sections
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | 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()`) 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())
256. Composition.section:sectionPregnancyHx.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`) 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())
258. Composition.section:sectionPregnancyHx.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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())
260. Composition.section:sectionPregnancyHx.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.
Short | Label 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.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
262. Composition.section:sectionPregnancyHx.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "10162-6" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
264. Composition.section:sectionPregnancyHx.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 10..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
266. Composition.section:sectionPregnancyHx.entry
Definition | It contains information about whether the patient is currently pregnant or not. It may contain addition summarizing information about the outcome of earlier pregnancies. A reference to the actual resource from which the narrative in the section is derived.
Short | Current pregnancy status and, optionally, information about the outcome of earlier pregnanciesA reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
268. Composition.section:sectionPregnancyHx.entry:pregnancyStatus
Slice Name | pregnancyStatus
Definition | Current pregnancy status A reference to the actual resource from which the narrative in the section is derived.
Short | Current pregnancy statusA reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Observation Pregnancy - Status (IPS), Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
270. Composition.section:sectionPregnancyHx.entry:pregnancyOutcome
Slice Name | pregnancyOutcome
Definition | Information about the outcome of earlier pregnancies A reference to the actual resource from which the narrative in the section is derived.
Short | Information about the outcome of earlier pregnanciesA reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Observation Pregnancy - Outcome (IPS), Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
272. Composition.section:sectionPregnancyHx.entry:gestationalAge
Slice Name | gestationalAge
Definition | Information about the gestational age of the pregnancy A reference to the actual resource from which the narrative in the section is derived.
Short | Information about the gestational age of the pregnancyA reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Observation Pregnancy - Gestational Age (EPS), Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
274. Composition.section:sectionPregnancyHx.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
276. Composition.section:sectionPatientStory
Slice Name | sectionPatientStory
Definition | The section contains narrative text along with optional resources that express what matters to a patient. This may include needs, strengths, values, concerns and preferences to others providing support and care. The patientâ€™s story, provided here, may be told by the patient or by a proxy. The root of the sections that make up the composition.
Short | EPS Patient Story SectionComposition is broken into sections
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | 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()`) 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())
278. Composition.section:sectionPatientStory.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`) 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())
280. Composition.section:sectionPatientStory.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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())
282. Composition.section:sectionPatientStory.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.
Short | Label 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.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
284. Composition.section:sectionPatientStory.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "81338-6" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
286. Composition.section:sectionPatientStory.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 10..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
288. Composition.section:sectionPatientStory.entry
Definition | Contains resources to support the Patient Story. Instances of DocumentReference or any other suitable resource type may be used. A reference to the actual resource from which the narrative in the section is derived.
Short | Patient Story resources.A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
290. Composition.section:sectionPatientStory.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
292. Composition.section:sectionPlanOfCare
Slice Name | sectionPlanOfCare
Definition | The plan of care section contains a narrative description of the expectations for care including proposals, goals, and order requests for monitoring, tracking, or improving the condition of the patient. The root of the sections that make up the composition.
Short | EPS Plan of Care SectionComposition is broken into sections
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | 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()`) 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())
294. Composition.section:sectionPlanOfCare.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`) 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())
296. Composition.section:sectionPlanOfCare.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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())
298. Composition.section:sectionPlanOfCare.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.
Short | Label 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.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
300. Composition.section:sectionPlanOfCare.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "18776-5" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
302. Composition.section:sectionPlanOfCare.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 10..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
304. Composition.section:sectionPlanOfCare.entry
Definition | Dynamic, personalized plan including identified needed healthcare activity, health objectives and healthcare goals, relating to one or more specified health issues in a healthcare process [Source EN ISO 13940] A reference to the actual resource from which the narrative in the section is derived.
Short | Optional entry used to represent structured care plansA reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(CarePlan, ImmunizationRecommendation, DocumentReference, Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
306. Composition.section:sectionPlanOfCare.entry:carePlan
Slice Name | carePlan
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | Optional slice used to represent care plansA reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(CarePlan, Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
308. Composition.section:sectionPlanOfCare.entry:immunizationRecommendation
Slice Name | immunizationRecommendation
Definition | A patient's point-in-time set of recommendations (i.e. forecasting) according to a published schedule with optional supporting justification. A reference to the actual resource from which the narrative in the section is derived.
Short | Optional slice used to represent immunization recommendationsA reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(ImmunizationRecommendation, Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
310. Composition.section:sectionPlanOfCare.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
312. Composition.section:sectionSocialHistory
Slice Name | sectionSocialHistory
Definition | The social history section contains a description of the personâ€™s Health related "lifestyle factors" or "lifestyle observations" (e.g. smoke habits; alcohol consumption; diets, risky habits.) The root of the sections that make up the composition.
Short | EPS Social History SectionComposition is broken into sections
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | 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()`) 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())
314. Composition.section:sectionSocialHistory.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`) 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())
316. Composition.section:sectionSocialHistory.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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())
318. Composition.section:sectionSocialHistory.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.
Short | Label 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.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
320. Composition.section:sectionSocialHistory.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "29762-2" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
322. Composition.section:sectionSocialHistory.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 10..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
324. Composition.section:sectionSocialHistory.entry
Definition | Description of the personâ€™s Health related "lifestyle observations" (e.g. smoke habits; alcohol consumption; diets, risky habits.) A reference to the actual resource from which the narrative in the section is derived.
Short | Health related "lifestyle factors" or "lifestyle observations" (e.g. smoke habits; alcohol consumption; diets, risky habits.)A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Observation, DocumentReference, Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
326. Composition.section:sectionSocialHistory.entry:smokingTobaccoUse
Slice Name | smokingTobaccoUse
Definition | A description of the personâ€™s smoke habits A reference to the actual resource from which the narrative in the section is derived.
Short | Smoke habitsA reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Observation Social History - Tobacco Use (IPS), Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
328. Composition.section:sectionSocialHistory.entry:alcoholUse
Slice Name | alcoholUse
Definition | A description of the personâ€™s alcohol consumption habits A reference to the actual resource from which the narrative in the section is derived.
Short | Alcohol consumptionA reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Observation Social History - Alcohol Use (IPS), Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
330. Composition.section:sectionSocialHistory.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
332. Composition.section:sectionVitalSigns
Slice Name | sectionVitalSigns
Definition | The Vital signs section includes blood pressure, body temperature, heart rate, and respiratory rate. It may also include other clinical findings, such as height, weight, body mass index, head circumference, and pulse oximetry. In particular, notable vital signs or physical findings such as the most recent, maximum and/or minimum, baseline, or relevant trends may be included The root of the sections that make up the composition.
Short | EPS Vital Signs SectionComposition is broken into sections
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | 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()`) 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())
334. Composition.section:sectionVitalSigns.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`) 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())
336. Composition.section:sectionVitalSigns.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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())
338. Composition.section:sectionVitalSigns.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.
Short | Label 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.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
340. Composition.section:sectionVitalSigns.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "8716-3" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
342. Composition.section:sectionVitalSigns.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 10..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
344. Composition.section:sectionVitalSigns.entry
Definition | Notable vital signs or physical findings as: blood pressure, body temperature, heart rate, and respiratory rate. It may also include other clinical findings, such as height, weight, body mass index, head circumference, and pulse oximetry. In particular, notable vital signs or physical findings such as the most recent, maximum and/or minimum, baseline, or relevant trends may be included A reference to the actual resource from which the narrative in the section is derived.
Short | Vital SignsA reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Observation, DocumentReference, Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
346. Composition.section:sectionVitalSigns.entry:vitalSign
Slice Name | vitalSign
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | Notable vital signs or physical findings.A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Vital Signs Profile, Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
348. Composition.section:sectionVitalSigns.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
350. Composition.section:sectionTravelHx
Slice Name | sectionTravelHx
Definition | This Section describes the travel history relevant for the Patient Summary, e.g.recent travel in a region of high prevalence of a specific infectious disease like Malaria The root of the sections that make up the composition.
Short | EPS Travel History SectionComposition is broken into sections
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | 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()`) 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())
352. Composition.section:sectionTravelHx.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`) 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())
354. Composition.section:sectionTravelHx.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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())
356. Composition.section:sectionTravelHx.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.
Short | Label 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.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
358. Composition.section:sectionTravelHx.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "10182-4" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
360. Composition.section:sectionTravelHx.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 10..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
362. Composition.section:sectionTravelHx.entry
Definition | Relevant information about the patient's recent travel history, for one visit A reference to the actual resource from which the narrative in the section is derived.
Short | Travel history observationA reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Observation, DocumentReference, Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
364. Composition.section:sectionTravelHx.entry:travelObservation
Slice Name | travelObservation
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Observation: country visited (EPS), Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
366. Composition.section:sectionTravelHx.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
368. Composition.section:sectionPatientHx
Slice Name | sectionPatientHx
Definition | This section may provide both synthetic anamnesis ,e.g. description of phases of the pathology as a chronological summary of clustered clinical information, and anecdotal evidence that clinicians can collect from the patient, and can read in a narrative form. The root of the sections that make up the composition.
Short | EPS Patient History SectionComposition is broken into sections
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | 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()`) 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())
370. Composition.section:sectionPatientHx.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`) 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())
372. Composition.section:sectionPatientHx.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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())
374. Composition.section:sectionPatientHx.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.
Short | Label 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.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
376. Composition.section:sectionPatientHx.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 10..1
Binding | For example codes, see DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "11329-0" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
378. Composition.section:sectionPatientHx.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 10..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
380. Composition.section:sectionPatientHx.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0* This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-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 | Patient Summary 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.
Short | Patient Summary composition
Impose Profile | This profile also requires that the instance also conform this additional profile: Composition (IPS)
2. Composition.meta
4. Composition.meta.profile
Obligations |
Obligations | Actor
MAY:able-to-populate | Creator (IPS)
6. Composition.text
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
8. Composition.extension
Slicing | This element introduces a set of slices on `Composition.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
10. Composition.extension:version
Slice Name | version
Short | Business version
Control | 0..1
Type | Extension(Cross-version Extension for R5.Composition.version for use in FHIR R4) (Extension Type: string)
12. Composition.identifier
Short | PS business identifier
Note | This is a business identifier, not a resource identifier (see discussion)
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
14. Composition.status
Short | PS status
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
16. Composition.type
Definition | Specifies that this composition refer to a Patient Summary
Short | Kind of composition ("Patient Summary")
Type | CodeableConcept(Codeable Concept (IPS))
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
18. Composition.subject
Definition | Who or what the composition is about. In general a 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). For the PS the subject is always the patient.
Control | 1..?
Type | Reference(Patient (EPS))
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
20. Composition.subject.reference
Control | 1..?
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
22. Composition.date
Short | PS date
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
24. Composition.author
Definition | Identifies who is responsible for the information in the Patient Summary, not necessarily who typed it in.
Short | Who and/or what authored the Patient Summary
Type | Reference(Practitioner (EU core), PractitionerRole (EU core), Device, Organization (EU core), Patient (EPS), RelatedPerson)
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
26. Composition.title
Definition | Official human-readable label for the composition. For this document should be "Patient Summary" or any equivalent translation
Short | Patient Summary
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
28. Composition.attester
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
30. Composition.attester.mode
Short | The type of attestation
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
32. Composition.attester.time
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
34. Composition.attester.party
Type | Reference(Practitioner (EU core), PractitionerRole (EU core), Organization (EU core), Patient (EPS), RelatedPerson)
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
36. Composition.custodian
Definition | Identifies the organization that is responsible for ongoing maintenance of the Patient Summary, and ensures that it remains available for access by other parties.
Short | Custodian of the Patient Summary
Type | Reference(Organization (EU core))
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
38. Composition.event
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
40. Composition.event.code
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
42. Composition.event.period
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
44. Composition.section
Definition | The root of the sections that make up the IPS composition.
Short | Sections composing the IPS
Control | 5..?
Obligations |
Obligations | Actor
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Invariants | ips-comp-1: Either section.entry or emptyReason are present (`(entry.reference.exists() or emptyReason.exists())`)
Slicing | This element introduces a set of slices on `Composition.section`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ code
46. Composition.section.extension
Slicing | This 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
48. Composition.section.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
50. Composition.section.title
Control | 1..?
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
52. Composition.section.code
Control | 1..?
Type | CodeableConcept(Codeable Concept (IPS))
Obligations |
Obligations | Actor
SHALL:handle | Consumer (IPS)
54. Composition.section.text
Control | 1..?
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
56. Composition.section.section
Control | 0..0
58. Composition.section:sectionProblems
Slice Name | sectionProblems
Definition | The EPS problem section lists and describes clinical problems or conditions currently being monitored for the patient.
Short | EPS Problems Section
Control | 1..1
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
60. Composition.section:sectionProblems.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
62. Composition.section:sectionProblems.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "11450-4" }] }`
64. Composition.section:sectionProblems.entry
Definition | It lists and describes clinical problems or conditions currently being monitored for the patient. This entry shall be used to document that no information about problems is available, or that no relevant problems are known.
Short | Clinical problems or conditions currently being monitored for the patient.
Type | Reference(Condition, DocumentReference)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
66. Composition.section:sectionProblems.entry:problem
Slice Name | problem
Definition | It lists and describes clinical problems or conditions currently being monitored for the patient. This entry shall be used to document that no information about problems is available, or that no relevant problems are known.
Control | 0..*
Type | Reference(Condition (EU core))
Obligations |
Obligations | Actor
SHALL:able-to-populate | Creator (IPS)
SHOULD:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
68. Composition.section:sectionProblems.emptyReason
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
70. Composition.section:sectionAllergies
Slice Name | sectionAllergies
Definition | This section documents the relevant allergies or intolerances for that patient, describing the kind of reaction - e.g. rash, anaphylaxis,.. - preferably the agents that cause it; and optionally the criticality and the certainty of the allergy. At a minimum, it should list currently active and any relevant historical allergies and adverse reactions. If no information about allergies is available, or if no allergies are known this should be clearly documented in the section.
Short | EPS Allergies and Intolerances Section
Control | 1..1
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
72. Composition.section:sectionAllergies.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
74. Composition.section:sectionAllergies.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "48765-2" }] }`
76. Composition.section:sectionAllergies.entry
Definition | allergyOrIntolerance
Short | allergyOrIntolerance
Type | Reference(AllergyIntolerance, DocumentReference)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
78. Composition.section:sectionAllergies.entry:allergyOrIntolerance
Slice Name | allergyOrIntolerance
Definition | It lists the relevant allergies or intolerances for that patient, describing the kind of reaction - e.g. rash, anaphylaxis,.. - preferably the agents that cause it; and optionally the criticality and the certainty of the allergy. At a minimum, it should list currently active and any relevant historical allergies and adverse reactions. If no information about allergies is available, or if no allergies are known this should be clearly documented in the section.
Short | Relevant allergies or intolerances for that patient.
Control | 0..*
Type | Reference(AllergyIntolerance (EU core))
Obligations |
Obligations | Actor
SHALL:able-to-populate | Creator (IPS)
SHOULD:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
80. Composition.section:sectionAllergies.emptyReason
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
82. Composition.section:sectionMedications
Slice Name | sectionMedications
Definition | The medication summary section contains a description of the patient's medications relevant for the scope of the patient summary. The actual content could depend on the jurisdiction, it could report: * the currently active medications; * the current and past medications considered relevant by the authoring GP; * the patient prescriptions or dispensations automatically extracted by a regional or a national EHR. In those cases medications are documented in the Patient Summary as medication statements or medication requests. This section requires either an entry indicating the subject is known not to be on any relevant medication; either an entry indicating that no information is available about medications; or entries summarizing the subject's relevant medications.
Short | EPS Medication Summary Section
Control | 1..1
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
84. Composition.section:sectionMedications.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
86. Composition.section:sectionMedications.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "10160-0" }] }`
88. Composition.section:sectionMedications.entry
Definition | medicationStatementOrRequest
Short | medicationStatementOrRequest
Type | Reference(MedicationStatement, MedicationRequest, MedicationAdministration, MedicationDispense, DocumentReference)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
90. Composition.section:sectionMedications.entry:medicationStatementOrRequest
Slice Name | medicationStatementOrRequest
Definition | This list the medications relevant for the scope of the patient summary or it is used to indicate that the subject is known not to be on any relevant medication; either that no information is available about medications.
Short | Medications relevant for the scope of the patient summary
Control | 0..*
Type | Reference(Medication Statement (EPS))
Obligations |
Obligations | Actor
SHALL:able-to-populate | Creator (IPS)
SHOULD:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
92. Composition.section:sectionMedications.emptyReason
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
94. Composition.section:sectionImmunizations
Slice Name | sectionImmunizations
Definition | The Immunizations Section defines a patient's current immunization status and pertinent immunization history. The primary use case for the Immunization Section is to enable communication of a patient's immunization status. The section includes the current immunization status, and may contain the entire immunization history that is relevant to the period of time being summarized.
Short | EPS Immunizations Section
Control | 0..1
Obligations |
Obligations | Actor
SHOULD:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
96. Composition.section:sectionImmunizations.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
98. Composition.section:sectionImmunizations.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "11369-6" }] }`
100. Composition.section:sectionImmunizations.entry
Definition | It defines the patient's current immunization status and pertinent immunization history. The primary use case for the Immunization Section is to enable communication of a patient's immunization status. It may contain the entire immunization history that is relevant to the period of time being summarized. This entry shall be used to document that no information about immunizations is available, or that no immunizations are known.
Short | Patient's immunization status and pertinent history.
Type | Reference(Immunization, DocumentReference)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
102. Composition.section:sectionImmunizations.entry:immunization
Slice Name | immunization
Control | 0..*
Type | Reference(Immunization (EU core))
Obligations |
Obligations | Actor
SHOULD:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
104. Composition.section:sectionResults
Slice Name | sectionResults
Definition | This section assembles relevant observation results collected on the patient or produced on in-vitro biologic specimens collected from the patient. Some of these results may be laboratory results, others may be anatomic pathology results, others, radiology results, and others, clinical results.
Short | EPS Results Section
Control | 0..1
Obligations |
Obligations | Actor
SHOULD:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
106. Composition.section:sectionResults.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
108. Composition.section:sectionResults.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "30954-2" }] }`
110. Composition.section:sectionResults.entry
Definition | EPS Results entry slice
Short | EPS Results entry
Type | Reference(Observation, DiagnosticReport, DocumentReference)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
112. Composition.section:sectionResults.entry:results-medicalTestResult
Slice Name | results-medicalTestResult
Definition | Results collected on the patient or produced on in-vitro biologic specimens.
Short | Medical test results
Control | 0..*
Type | Reference(Observation: Medical Test Result (EU core))
Obligations |
Obligations | Actor
SHOULD:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
114. Composition.section:sectionResults.entry:results-diagnosticReport
Slice Name | results-diagnosticReport
Definition | DiagnosticReport resource to represent diagnostic test and procedure reports in a patient summary
Short | EPS DiagnosticReport
Control | 0..*
Type | Reference(DiagnosticReport (EPS))
Obligations |
Obligations | Actor
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
116. Composition.section:sectionProceduresHx
Slice Name | sectionProceduresHx
Definition | The History of Procedures Section contains a description of the patient past procedures that are pertinent to the scope of this document. Procedures may refer for example to:
      1. Invasive Diagnostic procedure:e.g. Cardiac catheterization; (the results of these procedure are documented in the results section)

      2. Therapeutic procedure: e.g. dialysis;

      3. Surgical procedure: e.g. appendectomy
Short | EPS History of Procedures Section
Control | 1..1
Obligations |
Obligations | Actor
SHOULD:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
118. Composition.section:sectionProceduresHx.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
120. Composition.section:sectionProceduresHx.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "47519-4" }] }`
122. Composition.section:sectionProceduresHx.entry
Definition | Slice on procedure
Short | Slice on procedure
Type | Reference(Procedure, DocumentReference)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
124. Composition.section:sectionProceduresHx.entry:procedure
Slice Name | procedure
Definition | It lists the patient past procedures that are pertinent to the scope of this document. Procedures may refer for example to:
      1. Invasive Diagnostic procedure:e.g. Cardiac catheterization; (the results of these procedure are documented in the results section)

      2. Therapeutic procedure: e.g. dialysis;

      3. Surgical procedure: e.g. appendectomy
Short | Patient past procedures pertinent to the scope of this document.
Control | 0..*
Type | Reference(Procedure (EPS))
Obligations |
Obligations | Actor
SHOULD:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
126. Composition.section:sectionMedicalDevices
Slice Name | sectionMedicalDevices
Definition | The medical devices section contains narrative text and coded entries describing the patient history of medical device use.
Short | EPS Medical Devices Section
Control | 1..1
Obligations |
Obligations | Actor
SHOULD:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
128. Composition.section:sectionMedicalDevices.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
130. Composition.section:sectionMedicalDevices.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "46264-8" }] }`
132. Composition.section:sectionMedicalDevices.entry
Definition | EPS Medical Devices entry slice
Short | EPS Medical Device entry
Type | Reference(DeviceUseStatement, DocumentReference)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
134. Composition.section:sectionMedicalDevices.entry:deviceStatement
Slice Name | deviceStatement
Definition | It describes the patient history of medical device use. This entry shall be used to document that no information about medical device use is available, or that no relevant medical device use is known.
Short | Patient history of medical device use
Control | 0..*
Type | Reference(DeviceUseStatement (EPS))
Obligations |
Obligations | Actor
SHOULD:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
136. Composition.section:sectionAdvanceDirectives
Slice Name | sectionAdvanceDirectives
Definition | The advance directives section contains a narrative description of patient's advance directive.
Short | EPS Advance Directives Section
Control | 0..1
Obligations |
Obligations | Actor
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
138. Composition.section:sectionAdvanceDirectives.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
140. Composition.section:sectionAdvanceDirectives.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "42348-3" }] }`
142. Composition.section:sectionAdvanceDirectives.entry
Definition | Advance directives
Short | Advance directives
Type | Reference(Consent, DocumentReference)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
144. Composition.section:sectionAdvanceDirectives.entry:advanceDirectivesConsent
Slice Name | advanceDirectivesConsent
Definition | Contains a narrative description or a Consent entry with information about the patient's advance directive.
Short | Narrative description of the patient's advance directive.
Control | 0..*
Type | Reference(Consent (Advance Directives EPS))
146. Composition.section:sectionAlert
Slice Name | sectionAlert
Definition | The alerts section flags potential concerns and/or dangers to/from the patient and may also include obstacles to care.
Short | EPS Alerts Section
Control | 0..1
Obligations |
Obligations | Actor
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
148. Composition.section:sectionAlert.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
150. Composition.section:sectionAlert.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "104605-1" }] }`
152. Composition.section:sectionAlert.entry
Definition | EPS Alerts entry slice
Short | EPS Alerts entry
Type | Reference(Flag, DocumentReference)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
154. Composition.section:sectionAlert.entry:flag
Slice Name | flag
Definition | Contains alert information to be communicated. May optionally reference other resources in IPS.lags
Short | Alert information
Control | 0..*
Type | Reference(Flag:Patient (EU core))
156. Composition.section:sectionFunctionalStatus
Slice Name | sectionFunctionalStatus
Definition | The functional status section shall contain a narrative description of capability of the patient to perform acts of daily living, including possible needs of the patient to be continuously assessed by third parties. The invalidity status may in fact influence decisions about how to administer treatments. Profiles to express disabilities and functional assessments will be specified by future versions of this guide.
Short | EPS Functional Status
Control | 0..1
Obligations |
Obligations | Actor
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
158. Composition.section:sectionFunctionalStatus.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
160. Composition.section:sectionFunctionalStatus.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "47420-5" }] }`
162. Composition.section:sectionFunctionalStatus.entry
Definition | It describes capabilities of the patient to perform acts of daily living, including possible needs of the patient to be continuously assessed by third parties. The invalidity status may in fact influence decisions about how to administer treatments. Profiles to express disabilities and functional assessments will be specified by future versions of this guide.
Short | Optional entry used to represent disabilities and functional assessments
Type | Reference(Condition, ClinicalImpression, DocumentReference)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
164. Composition.section:sectionFunctionalStatus.entry:disability
Slice Name | disability
Short | Optional slice used to represent disabilities
Control | 0..*
Type | Reference(Condition (EU core))
166. Composition.section:sectionFunctionalStatus.entry:functionalAssessment
Slice Name | functionalAssessment
Short | Optional slice used to represent functional assessments
Control | 0..*
Type | Reference(ClinicalImpression)
168. Composition.section:sectionPregnancyHx
Slice Name | sectionPregnancyHx
Definition | The history of pregnancy section shall contain information about whether the patient is currently pregnant or not. It may contain addition summarizing information about the outcome of earlier pregnancies
Short | EPS History of Pregnancy Section
Control | 0..1
Obligations |
Obligations | Actor
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
170. Composition.section:sectionPregnancyHx.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
172. Composition.section:sectionPregnancyHx.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "10162-6" }] }`
174. Composition.section:sectionPregnancyHx.entry
Definition | It contains information about whether the patient is currently pregnant or not. It may contain addition summarizing information about the outcome of earlier pregnancies.
Short | Current pregnancy status and, optionally, information about the outcome of earlier pregnancies
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
176. Composition.section:sectionPregnancyHx.entry:pregnancyStatus
Slice Name | pregnancyStatus
Definition | Current pregnancy status
Short | Current pregnancy status
Control | 0..*
Type | Reference(Observation Pregnancy - Status (IPS))
178. Composition.section:sectionPregnancyHx.entry:pregnancyOutcome
Slice Name | pregnancyOutcome
Definition | Information about the outcome of earlier pregnancies
Short | Information about the outcome of earlier pregnancies
Control | 0..*
Type | Reference(Observation Pregnancy - Outcome (IPS))
180. Composition.section:sectionPregnancyHx.entry:gestationalAge
Slice Name | gestationalAge
Definition | Information about the gestational age of the pregnancy
Short | Information about the gestational age of the pregnancy
Control | 0..*
Type | Reference(Observation Pregnancy - Gestational Age (EPS))
182. Composition.section:sectionPatientStory
Slice Name | sectionPatientStory
Definition | The section contains narrative text along with optional resources that express what matters to a patient. This may include needs, strengths, values, concerns and preferences to others providing support and care. The patientâ€™s story, provided here, may be told by the patient or by a proxy.
Short | EPS Patient Story Section
Control | 0..1
Obligations |
Obligations | Actor
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
184. Composition.section:sectionPatientStory.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
186. Composition.section:sectionPatientStory.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "81338-6" }] }`
188. Composition.section:sectionPatientStory.entry
Definition | Contains resources to support the Patient Story. Instances of DocumentReference or any other suitable resource type may be used.
Short | Patient Story resources.
190. Composition.section:sectionPlanOfCare
Slice Name | sectionPlanOfCare
Definition | The plan of care section contains a narrative description of the expectations for care including proposals, goals, and order requests for monitoring, tracking, or improving the condition of the patient.
Short | EPS Plan of Care Section
Control | 0..1
Obligations |
Obligations | Actor
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
192. Composition.section:sectionPlanOfCare.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
194. Composition.section:sectionPlanOfCare.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "18776-5" }] }`
196. Composition.section:sectionPlanOfCare.entry
Definition | Dynamic, personalized plan including identified needed healthcare activity, health objectives and healthcare goals, relating to one or more specified health issues in a healthcare process [Source EN ISO 13940]
Short | Optional entry used to represent structured care plans
Type | Reference(CarePlan, ImmunizationRecommendation, DocumentReference)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
198. Composition.section:sectionPlanOfCare.entry:carePlan
Slice Name | carePlan
Short | Optional slice used to represent care plans
Control | 0..*
Type | Reference(CarePlan)
200. Composition.section:sectionPlanOfCare.entry:immunizationRecommendation
Slice Name | immunizationRecommendation
Definition | A patient's point-in-time set of recommendations (i.e. forecasting) according to a published schedule with optional supporting justification.
Short | Optional slice used to represent immunization recommendations
Control | 0..*
Type | Reference(ImmunizationRecommendation)
202. Composition.section:sectionSocialHistory
Slice Name | sectionSocialHistory
Definition | The social history section contains a description of the personâ€™s Health related "lifestyle factors" or "lifestyle observations" (e.g. smoke habits; alcohol consumption; diets, risky habits.)
Short | EPS Social History Section
Control | 0..1
Obligations |
Obligations | Actor
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
204. Composition.section:sectionSocialHistory.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
206. Composition.section:sectionSocialHistory.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "29762-2" }] }`
208. Composition.section:sectionSocialHistory.entry
Definition | Description of the personâ€™s Health related "lifestyle observations" (e.g. smoke habits; alcohol consumption; diets, risky habits.)
Short | Health related "lifestyle factors" or "lifestyle observations" (e.g. smoke habits; alcohol consumption; diets, risky habits.)
Type | Reference(Observation, DocumentReference)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
210. Composition.section:sectionSocialHistory.entry:smokingTobaccoUse
Slice Name | smokingTobaccoUse
Definition | A description of the personâ€™s smoke habits
Short | Smoke habits
Control | 0..*
Type | Reference(Observation Social History - Tobacco Use (IPS))
212. Composition.section:sectionSocialHistory.entry:alcoholUse
Slice Name | alcoholUse
Definition | A description of the personâ€™s alcohol consumption habits
Short | Alcohol consumption
Control | 0..*
Type | Reference(Observation Social History - Alcohol Use (IPS))
214. Composition.section:sectionVitalSigns
Slice Name | sectionVitalSigns
Definition | The Vital signs section includes blood pressure, body temperature, heart rate, and respiratory rate. It may also include other clinical findings, such as height, weight, body mass index, head circumference, and pulse oximetry. In particular, notable vital signs or physical findings such as the most recent, maximum and/or minimum, baseline, or relevant trends may be included
Short | EPS Vital Signs Section
Control | 0..1
Obligations |
Obligations | Actor
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
216. Composition.section:sectionVitalSigns.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
218. Composition.section:sectionVitalSigns.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "8716-3" }] }`
220. Composition.section:sectionVitalSigns.entry
Definition | Notable vital signs or physical findings as: blood pressure, body temperature, heart rate, and respiratory rate. It may also include other clinical findings, such as height, weight, body mass index, head circumference, and pulse oximetry. In particular, notable vital signs or physical findings such as the most recent, maximum and/or minimum, baseline, or relevant trends may be included
Short | Vital Signs
Type | Reference(Observation, DocumentReference)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
222. Composition.section:sectionVitalSigns.entry:vitalSign
Slice Name | vitalSign
Short | Notable vital signs or physical findings.
Control | 0..*
Type | Reference(Vital Signs Profile)
224. Composition.section:sectionTravelHx
Slice Name | sectionTravelHx
Definition | This Section describes the travel history relevant for the Patient Summary, e.g.recent travel in a region of high prevalence of a specific infectious disease like Malaria
Short | EPS Travel History Section
Control | 0..1
226. Composition.section:sectionTravelHx.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
228. Composition.section:sectionTravelHx.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "10182-4" }] }`
230. Composition.section:sectionTravelHx.entry
Definition | Relevant information about the patient's recent travel history, for one visit
Short | Travel history observation
Type | Reference(Observation, DocumentReference)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
232. Composition.section:sectionTravelHx.entry:travelObservation
Slice Name | travelObservation
Control | 0..*
Type | Reference(Observation: country visited (EPS))
234. Composition.section:sectionPatientHx
Slice Name | sectionPatientHx
Definition | This section may provide both synthetic anamnesis ,e.g. description of phases of the pathology as a chronological summary of clustered clinical information, and anecdotal evidence that clinicians can collect from the patient, and can read in a narrative form.
Short | EPS Patient History Section
Control | 0..1
236. Composition.section:sectionPatientHx.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
238. Composition.section:sectionPatientHx.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "11329-0" }] }`

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

0. Composition
Definition | Patient Summary 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.
Short | Patient Summary 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.
Control | 0..*
Is Modifier | false
Impose Profile | This profile also requires that the instance also conform this additional profile: Composition (IPS)
Summary | false
Invariants | dom-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.
Short | Logical 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.
Control | 0..1
Type | id
Is Modifier | false
Summary | true
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.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
6. Composition.meta.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
8. Composition.meta.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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`)
Slicing | This element introduces a set of slices on `Composition.meta.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
10. Composition.meta.versionId
Definition | The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.
Short | Version specific identifier
Comments | The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.
Control | 0..1
Type | id
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
12. Composition.meta.lastUpdated
Definition | When the resource last changed - e.g. when the version changed.
Short | When the resource version last changed
Comments | This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.
Control | 0..1
Type | instant
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
14. Composition.meta.source
Definition | A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.
Short | Identifies where the resource comes from
Comments | In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.
Control | 0..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
16. Composition.meta.profile
Definition | A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.
Short | Profiles this resource claims to conform to
Comments | It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.
Control | 0..*
Type | canonical(StructureDefinition)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
MAY:able-to-populate | Creator (IPS)
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
18. Composition.meta.security
Definition | Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.
Short | Security Labels applied to this resource
Comments | The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from All Security Labels (extensible to `http://hl7.org/fhir/ValueSet/security-labels|4.0.1` ) Security Labels from the Healthcare Privacy and Security Classification System.
Type | Coding
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
20. Composition.meta.tag
Definition | Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.
Short | Tags applied to this resource
Comments | The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.
Control | 0..*
Binding | For example codes, see CommonTags (example to `http://hl7.org/fhir/ValueSet/common-tags|4.0.1` ) Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
Type | Coding
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
22. 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.
Short | A 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.
Control | 0..1
Type | uri
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
24. Composition.language
Definition | The base language in which the resource is written.
Short | Language 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).
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages|4.0.1` ) A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
26. 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.
Short | Text 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.
Control | 0..1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
28. 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.
Short | Contained, 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.
Control | 0..*
Type | Resource
Is Modifier | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
30. Composition.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This element introduces a set of slices on `Composition.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
32. Composition.extension:version
Slice Name | version
Definition | This cross-version extension represents Composition.version from http://hl7.org/fhir/StructureDefinition/Composition|5.0.0 for use in FHIR R4.
Short | Business version
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Cross-version Extension for R5.Composition.version for use in FHIR R4) (Extension Type: string)
Is Modifier | false
Summary | false
Invariants | 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()`)
34. 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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
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 Names | extensions, user content
Invariants | 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()`)
36. Composition.identifier
Definition | A version-independent identifier for the Composition. This identifier stays constant as the composition is changed over time.
Short | PS business identifier
Comments | Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1
Type | Identifier
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
38. Composition.status
Definition | The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.
Short | PS status
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.
Control | 1..1
Binding | The 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.
Type | code
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | true
Requirements | Need to be able to mark interim, amended, or withdrawn compositions or documents.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
40. Composition.type
Definition | Specifies that this composition refer to a Patient Summary
Short | Kind of composition ("Patient Summary")
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.
Control | 1..1
Binding | The codes SHOULD be taken from FHIRDocumentTypeCodes (preferred to `http://hl7.org/fhir/ValueSet/doc-typecodes|4.0.1` ) Type of a composition.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
Summary | true
Requirements | Key metadata element describing the composition, used in searching/filtering.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
42. 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.
Short | Categorization of Composition
Comments | This is a metadata field from XDS/MHD.
Control | 0..*
Binding | For example codes, see DocumentClassValueSet (example to `http://hl7.org/fhir/ValueSet/document-classcodes|4.0.1` ) High-level kind of a clinical document at a macro level.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Helps humans to assess whether the composition is of interest when viewing an index of compositions or documents.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
44. Composition.subject
Definition | Who or what the composition is about. In general a 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). For the PS the subject is always the patient.
Short | Who and/or what the composition is about
Comments | For clinical documents, this is usually the patient.
Control | 1..1
Type | Reference(Patient (EPS))
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | true
Requirements | Essential metadata for searching for the composition. Identifies who and/or what the composition/document is about.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
46. Composition.subject.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
48. Composition.subject.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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`)
Slicing | This element introduces a set of slices on `Composition.subject.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
50. Composition.subject.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.
Short | Literal 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.
Control | 1..1 This element is affected by the following invariants: ref-1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
52. Composition.subject.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).
Short | Type 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.
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from ResourceType (extensible to `http://hl7.org/fhir/ValueSet/resource-types|4.0.1` ) Aa resource (or, for logical models, the URI of the logical model).
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
54. Composition.subject.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.
Short | Logical 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).
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1
Type | Identifier
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
56. Composition.subject.display
Definition | Plain text narrative that identifies the resource in addition to the resource reference.
Short | Text 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.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
58. Composition.encounter
Definition | Describes the clinical encounter or type of care this documentation is associated with.
Short | Context of the Composition
Control | 0..1
Type | Reference(Encounter)
Is Modifier | false
Summary | true
Requirements | Provides context for the composition and supports searching.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
60. Composition.date
Definition | The composition editing time, when the composition was last logically changed by the author.
Short | PS date
Comments | The Last Modified Date on the composition may be after the date of the document was attested without being changed.
Control | 1..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | true
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.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
62. Composition.author
Definition | Identifies who is responsible for the information in the Patient Summary, not necessarily who typed it in.
Short | Who and/or what authored the Patient Summary
Control | 1..*
Type | Reference(Practitioner (EU core), PractitionerRole (EU core), Device, Organization (EU core), Patient (EPS), RelatedPerson)
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | true
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
64. Composition.title
Definition | Official human-readable label for the composition. For this document should be "Patient Summary" or any equivalent translation
Short | Patient Summary
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.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
66. Composition.confidentiality
Definition | The code specifying the level of confidentiality of the Composition.
Short | As 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.
Control | 0..1
Binding | The 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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
68. Composition.attester
Definition | A participant who has attested to the accuracy of the composition/document.
Short | Attests to accuracy of composition
Comments | Only list each attester once.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Identifies responsibility for the accuracy of the composition content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
70. 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.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
72. 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`)
74. 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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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()`)
76. Composition.attester.mode
Definition | The type of attestation the authenticator offers.
Short | The type of attestation
Control | 1..1
Binding | The 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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Indicates the level of authority of the attestation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
78. Composition.attester.time
Definition | When the composition was attested by the party.
Short | When the composition was attested
Control | 0..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
80. Composition.attester.party
Definition | Who attested the composition in the specified way.
Short | Who attested the composition
Control | 0..1
Type | Reference(Practitioner (EU core), PractitionerRole (EU core), Organization (EU core), Patient (EPS), RelatedPerson)
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Identifies who has taken on the responsibility for accuracy of the composition content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
82. Composition.custodian
Definition | Identifies the organization that is responsible for ongoing maintenance of the Patient Summary, and ensures that it remains available for access by other parties.
Short | Custodian of the Patient Summary
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.
Control | 0..1
Type | Reference(Organization (EU core))
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | true
Requirements | Identifies where to go to find the current version, where to report issues, etc.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
84. Composition.relatesTo
Definition | Relationships that this composition has with other compositions or documents that already exist.
Short | Relationships to other compositions/documents
Comments | A document is a version specific composition.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
86. 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.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
88. 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`)
90. 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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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()`)
92. Composition.relatesTo.code
Definition | The type of relationship that this composition has with anther composition or document.
Short | replaces | transforms | signs | appends
Comments | If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.
Control | 1..1
Binding | The 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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
94. Composition.relatesTo.target[x]
Definition | The target composition/document of this relationship.
Short | Target of the relationship
Control | 1..1
Type | Choice of: Identifier, Reference(Composition)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
96. Composition.event
Definition | The clinical service, such as a colonoscopy or an appendectomy, being documented.
Short | The clinical service(s) being documented
Comments | The event needs to be consistent with the type element, though can provide further information if desired.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | true
Requirements | Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
98. 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.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
100. 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | 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()`)
102. 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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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()`)
104. 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.
Short | Code(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.
Control | 0..*
Binding | For 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.
Type | CodeableConcept
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
106. 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.
Short | The period covered by the documentation
Control | 0..1
Type | Period
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
108. 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.
Short | The event(s) being documented
Control | 0..*
Type | Reference(Resource)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
110. Composition.section
Definition | The root of the sections that make up the IPS composition.
Short | Sections composing the IPS
Control | 5..*
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | 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()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ips-comp-1: Either section.entry or emptyReason are present (`(entry.reference.exists() or emptyReason.exists())`)
Slicing | This element introduces a set of slices on `Composition.section`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ code
112. 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.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
114. Composition.section.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This 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.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`)
118. 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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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()`)
120. 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.
Short | Label 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.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
122. Composition.section.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:handle | Consumer (IPS)
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
124. Composition.section.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
126. 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).
Short | Who/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.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
128. 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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 1..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
130. 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.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The 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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
132. Composition.section.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order 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.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
134. Composition.section.entry
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
136. 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.
Short | Why 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.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
138. Composition.section.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
140. Composition.section:sectionProblems
Slice Name | sectionProblems
Definition | The EPS problem section lists and describes clinical problems or conditions currently being monitored for the patient.
Short | EPS Problems Section
Control | 1..1
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | 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()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
142. Composition.section:sectionProblems.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
144. Composition.section:sectionProblems.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This 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
146. Composition.section:sectionProblems.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`)
148. Composition.section:sectionProblems.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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()`)
150. Composition.section:sectionProblems.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.
Short | Label 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.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
152. Composition.section:sectionProblems.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "11450-4" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
154. Composition.section:sectionProblems.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
156. Composition.section:sectionProblems.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).
Short | Who/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.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
158. Composition.section:sectionProblems.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 1..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
160. Composition.section:sectionProblems.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.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The 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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
162. Composition.section:sectionProblems.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order 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.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
164. Composition.section:sectionProblems.entry
Definition | It lists and describes clinical problems or conditions currently being monitored for the patient. This entry shall be used to document that no information about problems is available, or that no relevant problems are known.
Short | Clinical problems or conditions currently being monitored for the patient.
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Condition, DocumentReference)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
166. Composition.section:sectionProblems.entry:problem
Slice Name | problem
Definition | It lists and describes clinical problems or conditions currently being monitored for the patient. This entry shall be used to document that no information about problems is available, or that no relevant problems are known.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Condition (EU core))
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:able-to-populate | Creator (IPS)
SHOULD:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
168. Composition.section:sectionProblems.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why 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.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
170. Composition.section:sectionProblems.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
172. Composition.section:sectionAllergies
Slice Name | sectionAllergies
Definition | This section documents the relevant allergies or intolerances for that patient, describing the kind of reaction - e.g. rash, anaphylaxis,.. - preferably the agents that cause it; and optionally the criticality and the certainty of the allergy. At a minimum, it should list currently active and any relevant historical allergies and adverse reactions. If no information about allergies is available, or if no allergies are known this should be clearly documented in the section.
Short | EPS Allergies and Intolerances Section
Control | 1..1
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | 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()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
174. Composition.section:sectionAllergies.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
176. Composition.section:sectionAllergies.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This 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
178. Composition.section:sectionAllergies.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`)
180. Composition.section:sectionAllergies.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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:sectionAllergies.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.
Short | Label 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.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
184. Composition.section:sectionAllergies.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "48765-2" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
186. Composition.section:sectionAllergies.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
188. Composition.section:sectionAllergies.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).
Short | Who/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.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
190. Composition.section:sectionAllergies.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 1..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
192. Composition.section:sectionAllergies.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.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The 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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
194. Composition.section:sectionAllergies.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order 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.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
196. Composition.section:sectionAllergies.entry
Definition | allergyOrIntolerance
Short | allergyOrIntolerance
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(AllergyIntolerance, DocumentReference)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
198. Composition.section:sectionAllergies.entry:allergyOrIntolerance
Slice Name | allergyOrIntolerance
Definition | It lists the relevant allergies or intolerances for that patient, describing the kind of reaction - e.g. rash, anaphylaxis,.. - preferably the agents that cause it; and optionally the criticality and the certainty of the allergy. At a minimum, it should list currently active and any relevant historical allergies and adverse reactions. If no information about allergies is available, or if no allergies are known this should be clearly documented in the section.
Short | Relevant allergies or intolerances for that patient.
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(AllergyIntolerance (EU core))
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:able-to-populate | Creator (IPS)
SHOULD:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
200. Composition.section:sectionAllergies.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why 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.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
202. Composition.section:sectionAllergies.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
204. Composition.section:sectionMedications
Slice Name | sectionMedications
Definition | The medication summary section contains a description of the patient's medications relevant for the scope of the patient summary. The actual content could depend on the jurisdiction, it could report: * the currently active medications; * the current and past medications considered relevant by the authoring GP; * the patient prescriptions or dispensations automatically extracted by a regional or a national EHR. In those cases medications are documented in the Patient Summary as medication statements or medication requests. This section requires either an entry indicating the subject is known not to be on any relevant medication; either an entry indicating that no information is available about medications; or entries summarizing the subject's relevant medications.
Short | EPS Medication Summary Section
Control | 1..1
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | 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()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
206. Composition.section:sectionMedications.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
208. Composition.section:sectionMedications.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This 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
210. Composition.section:sectionMedications.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`)
212. Composition.section:sectionMedications.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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()`)
214. Composition.section:sectionMedications.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.
Short | Label 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.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
216. Composition.section:sectionMedications.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "10160-0" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
218. Composition.section:sectionMedications.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
220. Composition.section:sectionMedications.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).
Short | Who/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.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
222. Composition.section:sectionMedications.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 1..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
224. Composition.section:sectionMedications.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.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The 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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
226. Composition.section:sectionMedications.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order 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.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
228. Composition.section:sectionMedications.entry
Definition | medicationStatementOrRequest
Short | medicationStatementOrRequest
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(MedicationStatement, MedicationRequest, MedicationAdministration, MedicationDispense, DocumentReference)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
230. Composition.section:sectionMedications.entry:medicationStatementOrRequest
Slice Name | medicationStatementOrRequest
Definition | This list the medications relevant for the scope of the patient summary or it is used to indicate that the subject is known not to be on any relevant medication; either that no information is available about medications.
Short | Medications relevant for the scope of the patient summary
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Medication Statement (EPS))
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:able-to-populate | Creator (IPS)
SHOULD:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
232. Composition.section:sectionMedications.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why 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.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
234. Composition.section:sectionMedications.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
236. Composition.section:sectionImmunizations
Slice Name | sectionImmunizations
Definition | The Immunizations Section defines a patient's current immunization status and pertinent immunization history. The primary use case for the Immunization Section is to enable communication of a patient's immunization status. The section includes the current immunization status, and may contain the entire immunization history that is relevant to the period of time being summarized.
Short | EPS Immunizations Section
Control | 0..1
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHOULD:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | 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()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
238. Composition.section:sectionImmunizations.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
240. Composition.section:sectionImmunizations.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This 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
242. Composition.section:sectionImmunizations.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`)
244. Composition.section:sectionImmunizations.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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()`)
246. Composition.section:sectionImmunizations.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.
Short | Label 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.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
248. Composition.section:sectionImmunizations.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "11369-6" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
250. Composition.section:sectionImmunizations.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
252. Composition.section:sectionImmunizations.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).
Short | Who/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.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
254. Composition.section:sectionImmunizations.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 1..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
256. Composition.section:sectionImmunizations.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.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The 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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
258. Composition.section:sectionImmunizations.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order 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.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
260. Composition.section:sectionImmunizations.entry
Definition | It defines the patient's current immunization status and pertinent immunization history. The primary use case for the Immunization Section is to enable communication of a patient's immunization status. It may contain the entire immunization history that is relevant to the period of time being summarized. This entry shall be used to document that no information about immunizations is available, or that no immunizations are known.
Short | Patient's immunization status and pertinent history.
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Immunization, DocumentReference)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
262. Composition.section:sectionImmunizations.entry:immunization
Slice Name | immunization
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Immunization (EU core))
Is Modifier | false
Obligations |
Obligations | Actor
SHOULD:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
264. Composition.section:sectionImmunizations.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why 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.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
266. Composition.section:sectionImmunizations.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
268. Composition.section:sectionResults
Slice Name | sectionResults
Definition | This section assembles relevant observation results collected on the patient or produced on in-vitro biologic specimens collected from the patient. Some of these results may be laboratory results, others may be anatomic pathology results, others, radiology results, and others, clinical results.
Short | EPS Results Section
Control | 0..1
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHOULD:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | 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()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
270. Composition.section:sectionResults.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
272. Composition.section:sectionResults.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This 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
274. Composition.section:sectionResults.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`)
276. Composition.section:sectionResults.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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()`)
278. Composition.section:sectionResults.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.
Short | Label 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.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
280. Composition.section:sectionResults.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "30954-2" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
282. Composition.section:sectionResults.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
284. Composition.section:sectionResults.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).
Short | Who/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.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
286. Composition.section:sectionResults.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 1..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
288. Composition.section:sectionResults.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.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The 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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
290. Composition.section:sectionResults.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order 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.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
292. Composition.section:sectionResults.entry
Definition | EPS Results entry slice
Short | EPS Results entry
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Observation, DiagnosticReport, DocumentReference)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
294. Composition.section:sectionResults.entry:results-medicalTestResult
Slice Name | results-medicalTestResult
Definition | Results collected on the patient or produced on in-vitro biologic specimens.
Short | Medical test results
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Observation: Medical Test Result (EU core))
Is Modifier | false
Obligations |
Obligations | Actor
SHOULD:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
296. Composition.section:sectionResults.entry:results-diagnosticReport
Slice Name | results-diagnosticReport
Definition | DiagnosticReport resource to represent diagnostic test and procedure reports in a patient summary
Short | EPS DiagnosticReport
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(DiagnosticReport (EPS))
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
298. Composition.section:sectionResults.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why 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.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
300. Composition.section:sectionResults.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
302. Composition.section:sectionProceduresHx
Slice Name | sectionProceduresHx
Definition | The History of Procedures Section contains a description of the patient past procedures that are pertinent to the scope of this document. Procedures may refer for example to:
      1. Invasive Diagnostic procedure:e.g. Cardiac catheterization; (the results of these procedure are documented in the results section)

      2. Therapeutic procedure: e.g. dialysis;

      3. Surgical procedure: e.g. appendectomy
Short | EPS History of Procedures Section
Control | 1..1
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHOULD:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | 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()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
304. Composition.section:sectionProceduresHx.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
306. Composition.section:sectionProceduresHx.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This 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
308. Composition.section:sectionProceduresHx.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`)
310. Composition.section:sectionProceduresHx.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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()`)
312. Composition.section:sectionProceduresHx.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.
Short | Label 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.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
314. Composition.section:sectionProceduresHx.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "47519-4" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
316. Composition.section:sectionProceduresHx.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
318. Composition.section:sectionProceduresHx.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).
Short | Who/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.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
320. Composition.section:sectionProceduresHx.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 1..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
322. Composition.section:sectionProceduresHx.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.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The 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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
324. Composition.section:sectionProceduresHx.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order 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.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
326. Composition.section:sectionProceduresHx.entry
Definition | Slice on procedure
Short | Slice on procedure
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Procedure, DocumentReference)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
328. Composition.section:sectionProceduresHx.entry:procedure
Slice Name | procedure
Definition | It lists the patient past procedures that are pertinent to the scope of this document. Procedures may refer for example to:
      1. Invasive Diagnostic procedure:e.g. Cardiac catheterization; (the results of these procedure are documented in the results section)

      2. Therapeutic procedure: e.g. dialysis;

      3. Surgical procedure: e.g. appendectomy
Short | Patient past procedures pertinent to the scope of this document.
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Procedure (EPS))
Is Modifier | false
Obligations |
Obligations | Actor
SHOULD:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
330. Composition.section:sectionProceduresHx.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why 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.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
332. Composition.section:sectionProceduresHx.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
334. Composition.section:sectionMedicalDevices
Slice Name | sectionMedicalDevices
Definition | The medical devices section contains narrative text and coded entries describing the patient history of medical device use.
Short | EPS Medical Devices Section
Control | 1..1
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHOULD:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | 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()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
336. Composition.section:sectionMedicalDevices.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
338. Composition.section:sectionMedicalDevices.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This 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
340. Composition.section:sectionMedicalDevices.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`)
342. Composition.section:sectionMedicalDevices.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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()`)
344. Composition.section:sectionMedicalDevices.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.
Short | Label 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.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
346. Composition.section:sectionMedicalDevices.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "46264-8" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
348. Composition.section:sectionMedicalDevices.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
350. Composition.section:sectionMedicalDevices.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).
Short | Who/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.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
352. Composition.section:sectionMedicalDevices.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 1..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
354. Composition.section:sectionMedicalDevices.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.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The 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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
356. Composition.section:sectionMedicalDevices.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order 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.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
358. Composition.section:sectionMedicalDevices.entry
Definition | EPS Medical Devices entry slice
Short | EPS Medical Device entry
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(DeviceUseStatement, DocumentReference)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
360. Composition.section:sectionMedicalDevices.entry:deviceStatement
Slice Name | deviceStatement
Definition | It describes the patient history of medical device use. This entry shall be used to document that no information about medical device use is available, or that no relevant medical device use is known.
Short | Patient history of medical device use
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(DeviceUseStatement (EPS))
Is Modifier | false
Obligations |
Obligations | Actor
SHOULD:populate-if-known | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
362. Composition.section:sectionMedicalDevices.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why 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.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
364. Composition.section:sectionMedicalDevices.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
366. Composition.section:sectionAdvanceDirectives
Slice Name | sectionAdvanceDirectives
Definition | The advance directives section contains a narrative description of patient's advance directive.
Short | EPS Advance Directives Section
Control | 0..1
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | 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()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
368. Composition.section:sectionAdvanceDirectives.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
370. Composition.section:sectionAdvanceDirectives.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This 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
372. Composition.section:sectionAdvanceDirectives.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`)
374. Composition.section:sectionAdvanceDirectives.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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()`)
376. Composition.section:sectionAdvanceDirectives.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.
Short | Label 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.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
378. Composition.section:sectionAdvanceDirectives.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "42348-3" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
380. Composition.section:sectionAdvanceDirectives.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
382. Composition.section:sectionAdvanceDirectives.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).
Short | Who/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.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
384. Composition.section:sectionAdvanceDirectives.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 1..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
386. Composition.section:sectionAdvanceDirectives.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.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The 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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
388. Composition.section:sectionAdvanceDirectives.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order 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.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
390. Composition.section:sectionAdvanceDirectives.entry
Definition | Advance directives
Short | Advance directives
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Consent, DocumentReference)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
392. Composition.section:sectionAdvanceDirectives.entry:advanceDirectivesConsent
Slice Name | advanceDirectivesConsent
Definition | Contains a narrative description or a Consent entry with information about the patient's advance directive.
Short | Narrative description of the patient's advance directive.
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Consent (Advance Directives EPS))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
394. Composition.section:sectionAdvanceDirectives.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why 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.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
396. Composition.section:sectionAdvanceDirectives.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
398. Composition.section:sectionAlert
Slice Name | sectionAlert
Definition | The alerts section flags potential concerns and/or dangers to/from the patient and may also include obstacles to care.
Short | EPS Alerts Section
Control | 0..1
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | 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()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
400. Composition.section:sectionAlert.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
402. Composition.section:sectionAlert.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This 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
404. Composition.section:sectionAlert.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`)
406. Composition.section:sectionAlert.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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()`)
408. Composition.section:sectionAlert.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.
Short | Label 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.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
410. Composition.section:sectionAlert.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "104605-1" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
412. Composition.section:sectionAlert.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
414. Composition.section:sectionAlert.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).
Short | Who/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.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
416. Composition.section:sectionAlert.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 1..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
418. Composition.section:sectionAlert.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.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The 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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
420. Composition.section:sectionAlert.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order 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.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
422. Composition.section:sectionAlert.entry
Definition | EPS Alerts entry slice
Short | EPS Alerts entry
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Flag, DocumentReference)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
424. Composition.section:sectionAlert.entry:flag
Slice Name | flag
Definition | Contains alert information to be communicated. May optionally reference other resources in IPS.lags
Short | Alert information
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Flag:Patient (EU core))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
426. Composition.section:sectionAlert.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why 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.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
428. Composition.section:sectionAlert.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
430. Composition.section:sectionFunctionalStatus
Slice Name | sectionFunctionalStatus
Definition | The functional status section shall contain a narrative description of capability of the patient to perform acts of daily living, including possible needs of the patient to be continuously assessed by third parties. The invalidity status may in fact influence decisions about how to administer treatments. Profiles to express disabilities and functional assessments will be specified by future versions of this guide.
Short | EPS Functional Status
Control | 0..1
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | 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()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
432. Composition.section:sectionFunctionalStatus.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
434. Composition.section:sectionFunctionalStatus.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This 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
436. Composition.section:sectionFunctionalStatus.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`)
438. Composition.section:sectionFunctionalStatus.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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()`)
440. Composition.section:sectionFunctionalStatus.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.
Short | Label 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.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
442. Composition.section:sectionFunctionalStatus.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "47420-5" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
444. Composition.section:sectionFunctionalStatus.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
446. Composition.section:sectionFunctionalStatus.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).
Short | Who/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.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
448. Composition.section:sectionFunctionalStatus.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 1..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
450. Composition.section:sectionFunctionalStatus.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.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The 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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
452. Composition.section:sectionFunctionalStatus.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order 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.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
454. Composition.section:sectionFunctionalStatus.entry
Definition | It describes capabilities of the patient to perform acts of daily living, including possible needs of the patient to be continuously assessed by third parties. The invalidity status may in fact influence decisions about how to administer treatments. Profiles to express disabilities and functional assessments will be specified by future versions of this guide.
Short | Optional entry used to represent disabilities and functional assessments
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Condition, ClinicalImpression, DocumentReference)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
456. Composition.section:sectionFunctionalStatus.entry:disability
Slice Name | disability
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | Optional slice used to represent disabilities
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Condition (EU core))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
458. Composition.section:sectionFunctionalStatus.entry:functionalAssessment
Slice Name | functionalAssessment
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | Optional slice used to represent functional assessments
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(ClinicalImpression)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
460. Composition.section:sectionFunctionalStatus.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why 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.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
462. Composition.section:sectionFunctionalStatus.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
464. Composition.section:sectionPregnancyHx
Slice Name | sectionPregnancyHx
Definition | The history of pregnancy section shall contain information about whether the patient is currently pregnant or not. It may contain addition summarizing information about the outcome of earlier pregnancies
Short | EPS History of Pregnancy Section
Control | 0..1
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | 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()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
466. Composition.section:sectionPregnancyHx.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
468. Composition.section:sectionPregnancyHx.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This 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
470. Composition.section:sectionPregnancyHx.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`)
472. Composition.section:sectionPregnancyHx.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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()`)
474. Composition.section:sectionPregnancyHx.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.
Short | Label 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.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
476. Composition.section:sectionPregnancyHx.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "10162-6" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
478. Composition.section:sectionPregnancyHx.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
480. Composition.section:sectionPregnancyHx.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).
Short | Who/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.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
482. Composition.section:sectionPregnancyHx.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 1..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
484. Composition.section:sectionPregnancyHx.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.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The 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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
486. Composition.section:sectionPregnancyHx.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order 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.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
488. Composition.section:sectionPregnancyHx.entry
Definition | It contains information about whether the patient is currently pregnant or not. It may contain addition summarizing information about the outcome of earlier pregnancies.
Short | Current pregnancy status and, optionally, information about the outcome of earlier pregnancies
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
490. Composition.section:sectionPregnancyHx.entry:pregnancyStatus
Slice Name | pregnancyStatus
Definition | Current pregnancy status
Short | Current pregnancy status
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Observation Pregnancy - Status (IPS))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
492. Composition.section:sectionPregnancyHx.entry:pregnancyOutcome
Slice Name | pregnancyOutcome
Definition | Information about the outcome of earlier pregnancies
Short | Information about the outcome of earlier pregnancies
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Observation Pregnancy - Outcome (IPS))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
494. Composition.section:sectionPregnancyHx.entry:gestationalAge
Slice Name | gestationalAge
Definition | Information about the gestational age of the pregnancy
Short | Information about the gestational age of the pregnancy
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Observation Pregnancy - Gestational Age (EPS))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
496. Composition.section:sectionPregnancyHx.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why 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.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
498. Composition.section:sectionPregnancyHx.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
500. Composition.section:sectionPatientStory
Slice Name | sectionPatientStory
Definition | The section contains narrative text along with optional resources that express what matters to a patient. This may include needs, strengths, values, concerns and preferences to others providing support and care. The patientâ€™s story, provided here, may be told by the patient or by a proxy.
Short | EPS Patient Story Section
Control | 0..1
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | 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()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
502. Composition.section:sectionPatientStory.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
504. Composition.section:sectionPatientStory.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This 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
506. Composition.section:sectionPatientStory.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`)
508. Composition.section:sectionPatientStory.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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()`)
510. Composition.section:sectionPatientStory.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.
Short | Label 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.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
512. Composition.section:sectionPatientStory.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "81338-6" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
514. Composition.section:sectionPatientStory.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
516. Composition.section:sectionPatientStory.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).
Short | Who/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.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
518. Composition.section:sectionPatientStory.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 1..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
520. Composition.section:sectionPatientStory.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.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The 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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
522. Composition.section:sectionPatientStory.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order 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.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
524. Composition.section:sectionPatientStory.entry
Definition | Contains resources to support the Patient Story. Instances of DocumentReference or any other suitable resource type may be used.
Short | Patient Story resources.
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
526. Composition.section:sectionPatientStory.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why 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.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
528. Composition.section:sectionPatientStory.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
530. Composition.section:sectionPlanOfCare
Slice Name | sectionPlanOfCare
Definition | The plan of care section contains a narrative description of the expectations for care including proposals, goals, and order requests for monitoring, tracking, or improving the condition of the patient.
Short | EPS Plan of Care Section
Control | 0..1
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | 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()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
532. Composition.section:sectionPlanOfCare.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
534. Composition.section:sectionPlanOfCare.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This 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
536. Composition.section:sectionPlanOfCare.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`)
538. Composition.section:sectionPlanOfCare.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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()`)
540. Composition.section:sectionPlanOfCare.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.
Short | Label 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.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
542. Composition.section:sectionPlanOfCare.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "18776-5" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
544. Composition.section:sectionPlanOfCare.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
546. Composition.section:sectionPlanOfCare.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).
Short | Who/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.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
548. Composition.section:sectionPlanOfCare.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 1..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
550. Composition.section:sectionPlanOfCare.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.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The 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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
552. Composition.section:sectionPlanOfCare.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order 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.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
554. Composition.section:sectionPlanOfCare.entry
Definition | Dynamic, personalized plan including identified needed healthcare activity, health objectives and healthcare goals, relating to one or more specified health issues in a healthcare process [Source EN ISO 13940]
Short | Optional entry used to represent structured care plans
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(CarePlan, ImmunizationRecommendation, DocumentReference)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
556. Composition.section:sectionPlanOfCare.entry:carePlan
Slice Name | carePlan
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | Optional slice used to represent care plans
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(CarePlan)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
558. Composition.section:sectionPlanOfCare.entry:immunizationRecommendation
Slice Name | immunizationRecommendation
Definition | A patient's point-in-time set of recommendations (i.e. forecasting) according to a published schedule with optional supporting justification.
Short | Optional slice used to represent immunization recommendations
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(ImmunizationRecommendation)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
560. Composition.section:sectionPlanOfCare.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why 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.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
562. Composition.section:sectionPlanOfCare.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
564. Composition.section:sectionSocialHistory
Slice Name | sectionSocialHistory
Definition | The social history section contains a description of the personâ€™s Health related "lifestyle factors" or "lifestyle observations" (e.g. smoke habits; alcohol consumption; diets, risky habits.)
Short | EPS Social History Section
Control | 0..1
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | 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()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
566. Composition.section:sectionSocialHistory.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
568. Composition.section:sectionSocialHistory.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This 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
570. Composition.section:sectionSocialHistory.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`)
572. Composition.section:sectionSocialHistory.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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()`)
574. Composition.section:sectionSocialHistory.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.
Short | Label 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.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
576. Composition.section:sectionSocialHistory.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "29762-2" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
578. Composition.section:sectionSocialHistory.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
580. Composition.section:sectionSocialHistory.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).
Short | Who/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.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
582. Composition.section:sectionSocialHistory.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 1..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
584. Composition.section:sectionSocialHistory.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.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The 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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
586. Composition.section:sectionSocialHistory.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order 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.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
588. Composition.section:sectionSocialHistory.entry
Definition | Description of the personâ€™s Health related "lifestyle observations" (e.g. smoke habits; alcohol consumption; diets, risky habits.)
Short | Health related "lifestyle factors" or "lifestyle observations" (e.g. smoke habits; alcohol consumption; diets, risky habits.)
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Observation, DocumentReference)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
590. Composition.section:sectionSocialHistory.entry:smokingTobaccoUse
Slice Name | smokingTobaccoUse
Definition | A description of the personâ€™s smoke habits
Short | Smoke habits
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Observation Social History - Tobacco Use (IPS))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
592. Composition.section:sectionSocialHistory.entry:alcoholUse
Slice Name | alcoholUse
Definition | A description of the personâ€™s alcohol consumption habits
Short | Alcohol consumption
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Observation Social History - Alcohol Use (IPS))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
594. Composition.section:sectionSocialHistory.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why 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.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
596. Composition.section:sectionSocialHistory.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
598. Composition.section:sectionVitalSigns
Slice Name | sectionVitalSigns
Definition | The Vital signs section includes blood pressure, body temperature, heart rate, and respiratory rate. It may also include other clinical findings, such as height, weight, body mass index, head circumference, and pulse oximetry. In particular, notable vital signs or physical findings such as the most recent, maximum and/or minimum, baseline, or relevant trends may be included
Short | EPS Vital Signs Section
Control | 0..1
Type | BackboneElement
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | 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()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
600. Composition.section:sectionVitalSigns.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
602. Composition.section:sectionVitalSigns.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This 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
604. Composition.section:sectionVitalSigns.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`)
606. Composition.section:sectionVitalSigns.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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()`)
608. Composition.section:sectionVitalSigns.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.
Short | Label 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.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
610. Composition.section:sectionVitalSigns.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "8716-3" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
612. Composition.section:sectionVitalSigns.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
614. Composition.section:sectionVitalSigns.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).
Short | Who/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.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
616. Composition.section:sectionVitalSigns.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 1..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
618. Composition.section:sectionVitalSigns.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.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The 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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
620. Composition.section:sectionVitalSigns.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order 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.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
622. Composition.section:sectionVitalSigns.entry
Definition | Notable vital signs or physical findings as: blood pressure, body temperature, heart rate, and respiratory rate. It may also include other clinical findings, such as height, weight, body mass index, head circumference, and pulse oximetry. In particular, notable vital signs or physical findings such as the most recent, maximum and/or minimum, baseline, or relevant trends may be included
Short | Vital Signs
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Observation, DocumentReference)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
624. Composition.section:sectionVitalSigns.entry:vitalSign
Slice Name | vitalSign
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | Notable vital signs or physical findings.
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Vital Signs Profile)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
626. Composition.section:sectionVitalSigns.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why 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.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
628. Composition.section:sectionVitalSigns.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
630. Composition.section:sectionTravelHx
Slice Name | sectionTravelHx
Definition | This Section describes the travel history relevant for the Patient Summary, e.g.recent travel in a region of high prevalence of a specific infectious disease like Malaria
Short | EPS Travel History Section
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | 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()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
632. Composition.section:sectionTravelHx.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
634. Composition.section:sectionTravelHx.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This 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
636. Composition.section:sectionTravelHx.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`)
638. Composition.section:sectionTravelHx.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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()`)
640. Composition.section:sectionTravelHx.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.
Short | Label 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.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
642. Composition.section:sectionTravelHx.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "10182-4" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
644. Composition.section:sectionTravelHx.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
646. Composition.section:sectionTravelHx.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).
Short | Who/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.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
648. Composition.section:sectionTravelHx.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 1..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
650. Composition.section:sectionTravelHx.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.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The 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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
652. Composition.section:sectionTravelHx.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order 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.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
654. Composition.section:sectionTravelHx.entry
Definition | Relevant information about the patient's recent travel history, for one visit
Short | Travel history observation
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Observation, DocumentReference)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Composition.section.entry`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ resolve()
656. Composition.section:sectionTravelHx.entry:travelObservation
Slice Name | travelObservation
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Observation: country visited (EPS))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
658. Composition.section:sectionTravelHx.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why 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.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
660. Composition.section:sectionTravelHx.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
662. Composition.section:sectionPatientHx
Slice Name | sectionPatientHx
Definition | This section may provide both synthetic anamnesis ,e.g. description of phases of the pathology as a chronological summary of clustered clinical information, and anecdotal evidence that clinicians can collect from the patient, and can read in a narrative form.
Short | EPS Patient History Section
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | false
Invariants | 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()`) ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
664. Composition.section:sectionPatientHx.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
666. Composition.section:sectionPatientHx.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | 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()`)
Slicing | This 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
668. Composition.section:sectionPatientHx.extension:section-note
Slice Name | section-note
Definition | Additional notes that apply to the section (but not to specific resource).
Short | Additional notes that apply to the section (but not to specific resource).
Comments | This extension SHALL NOT be used if the resource already has standard 'note' element (or equivalent) of type Annotation on the same element
Control | 0..*
Type | Extension(Note) (Extension Type: Annotation)
Is Modifier | false
Summary | false
Invariants | 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()`)
670. Composition.section:sectionPatientHx.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | 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()`)
672. Composition.section:sectionPatientHx.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.
Short | Label 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.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Requirements | Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.
Alternate Names | header, label, caption
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
674. Composition.section:sectionPatientHx.code
Definition | A code identifying the kind of content contained within the section. This must be consistent with the section title.
Short | Classification 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.
Control | 1..1
Binding | For example codes, see DocumentSectionCodes (example to `http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1` ) Classification of a section of a composition/document.
Type | CodeableConcept(Codeable Concept (IPS))
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "11329-0" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
676. Composition.section:sectionPatientHx.author
Definition | Identifies who is responsible for the information in this section, not necessarily who typed it in.
Short | Who and/or what authored the section
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
Summary | false
Requirements | Identifies who is responsible for the content.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
678. Composition.section:sectionPatientHx.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).
Short | Who/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.
Control | 0..1
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
680. Composition.section:sectionPatientHx.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.
Short | Text summary of the section, for human interpretation
Comments | Document profiles may define what content should be represented in the narrative to ensure clinical safety.
Control | 1..1 This element is affected by the following invariants: cmp-1
Type | Narrative
Is Modifier | false
Obligations |
Obligations | Actor
SHALL:populate | Creator (IPS)
SHALL:handle | Consumer (IPS)
SHOULD:display | Consumer (IPS)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
682. Composition.section:sectionPatientHx.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.
Short | working | snapshot | changes
Comments | This element is labeled as a modifier because a change list must not be misunderstood as a complete list.
Control | 0..1
Binding | The 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.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
684. Composition.section:sectionPatientHx.orderedBy
Definition | Specifies the order applied to the items in the section entries.
Short | Order 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.
Control | 0..1
Binding | The codes SHOULD be taken from ListOrderCodes (preferred to `http://hl7.org/fhir/ValueSet/list-order|4.0.1` ) What order applies to the items in the entry.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
686. Composition.section:sectionPatientHx.entry
Definition | A reference to the actual resource from which the narrative in the section is derived.
Short | A reference to data that supports this section
Comments | If there are no entries in the list, an emptyReason SHOULD be provided.
Control | 0..* This element is affected by the following invariants: cmp-2
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
688. Composition.section:sectionPatientHx.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Why 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.
Control | 0..1 This element is affected by the following invariants: cmp-2
Binding | The codes SHOULD be taken from ListEmptyReasons (preferred to `http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1` ) If a section is empty, why it is empty.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows capturing things like "none exist" or "not asked" which can be important for most lists.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
690. Composition.section:sectionPatientHx.section
Definition | A nested sub-section within this section.
Short | Nested Section
Comments | Nested sections are primarily used to help human readers navigate to particular portions of the document.
Control | 0..0 This element is affected by the following invariants: cmp-1
Type | Seettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)