HL7 Europe Laboratory Report
2.0.0 - ci-build 150

HL7 Europe Laboratory Report - Downloaded Version 2.0.0 See the Directory of published versions

## Resource Profile: CompositionLabReportEu - Detailed Descriptions

Page standards status: Trial-use | Maturity Level: 2

Definitions for the Composition-eu-lab 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 | Laboratory Report composition. A composition is a set of healthcare-related information that is assembled together into a single logical document that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. While a Composition defines the structure, it does not actually contain the content: rather the full content of a document is contained in a Bundle, of which the Composition is the first resource contained. 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 | Laboratory Report compositionA set of resources composed into a single coherent clinical statement with clinical attestation
Comments | While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical.
Control | 0..*
Is Modifier | false
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 | Narrative textText 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
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:version
Slice Name | version
Definition | R5: `Composition.version` (new:string)
Short | R5: An explicitly assigned identifer of a variation of the content in the Composition (new)
Comments | Element `Composition.version` has a context of Composition based on following the parent source element upwards and mapping to `Composition`. Element `Composition.version` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). While each resource, including the composition itself, has its own version identifier, this is a formal identifier for the logical version of the Composition as a whole. It would remain constant if the resources were moved to a new server, and all got new individual resource versions, for example.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(R5: An explicitly assigned identifer of a variation of the content in the Composition (new)) (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())
8. Composition.extension:version.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..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()`) 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.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
10. Composition.extension:version.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/5.0/StructureDefinition/extension-Composition.version`
12. Composition.extension:informationRecipient
Slice Name | informationRecipient
Definition | This extension applies to the Composition resource and is used to represent an intended recipient of the composition.
Short | Composition: Information recipient
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(Composition: Information recipient) (Extension Type: Reference(Practitioner, Device, Patient, RelatedPerson, PractitionerRole, Organization, CareTeam, Group))
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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
14. Composition.extension:informationRecipient.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..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.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
16. Composition.extension:informationRecipient.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.eu/fhir/StructureDefinition/information-recipient`
18. Composition.extension:diagnosticReport
Slice Name | diagnosticReport
Definition | This extension provides a reference to the DiagnosticReport instance that is associated with this Composition.
Short | Document DiagnosticReport Reference
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Document DiagnosticReport Reference) (Extension Type: Reference(DiagnosticReport))
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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
20. Composition.extension:diagnosticReport.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..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.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
22. Composition.extension:diagnosticReport.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.eu/fhir/extensions/StructureDefinition/composition-diagnosticReportReference`
24. Composition.extension:diagnosticReport.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 10..1
Type | Reference(DiagnosticReport), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] 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()))
26. Composition.extension:diagnosticReport.value[x].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 | Added to the FHIR R4 guide to allow strictly conformance with the R4 rules for document bundle resources inclusion. Using this extension implies to accept a circular reference Composition to/from DiagnosticReport 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
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. 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())
30. Composition.identifier
Definition | Identifiers assigned to this document by the performer or other systems. Should remain stable across versions of the report. A version-independent identifier for the Composition. This identifier stays constant as the composition is changed over time.
Short | Report identifierVersion-independent identifier for the Composition
Comments | Composition.identifier SHALL be equal to one of the DiagnosticReport.identifier, if at least one exists 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 | 10..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()))
32. Composition.status
Definition | The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.
Short | preliminary | 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
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()))
34. Composition.type
Definition | Specifies that it refers to a Laboratory Report 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 | Type of (Laboratory) ReportKind of composition (LOINC if possible)
Comments | At least one DiagnosticReport.code.coding and Composition.type.coding SHALL be equal 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 Laboratory Report Types http://hl7.org/fhir/ValueSet/doc-typecodes|4.0.1 (preferred to `http://hl7.eu/fhir/laboratory/ValueSet/lab-reportType-eu-lab` )
Type | CodeableConcept
Is Modifier | false
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()))
36. Composition.category
Definition | A code that classifies this laboratory report. Two basic categories has been selected in this guide: laboratory specialty and Study type. Laboratory specialty is characteristic of the laboratory that produced the test result while Study type is an arbitrary classificion of the test type. 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 | Report CategoryCategorization of Composition
Comments | DiagnosticReport.category and Composition.category shall be aligned This is a metadata field from XDS/MHD.
Control | 0..*
Binding | For example codes, see DocumentClassValueSet http://hl7.org/fhir/ValueSet/document-classcodes|4.0.1 (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()))
Slicing | This element introduces a set of slices on `Composition.category`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ $this
38. Composition.category:studyType
Slice Name | studyType
Definition | Laboratory services, i.e., results of tests performed, could be characterized using typology of services, commonly called study types. Study type could be seen as an attribute or grouping mechanism that assigns a common clinical sense to certain types of laboratory test results., e.g., Hemoglobin, Platelet count, etc. belongs to 'Hematology study'. 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 | The way of grouping of the test results into clinically meaningful domains (e.g. hematology study, microbiology study, etc.)Categorization of Composition
Comments | In comparison to the laboratory specialty which is an attribute of laboratory, study type is a categorization of laboratory service. It needs to be mentioned that classification of test to study types in not standardized. This is a metadata field from XDS/MHD.
Control | 0..*
Binding | The codes SHALL be taken from For example codes, see Laboratory Study Types http://hl7.org/fhir/ValueSet/document-classcodes|4.0.1 (required to `http://hl7.eu/fhir/laboratory/ValueSet/lab-studyType-eu-lab` )
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()))
40. Composition.category:specialty
Slice Name | specialty
Definition | Laboratory specialty is an attribute of any laboratory setting representing professional qualification of the laboratory to execute certain kind of laboratory tests. 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 | The clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry)Categorization of Composition
Comments | Specialty could be used as parameter for searching/querying of laboratory test results. This is a metadata field from XDS/MHD.
Control | 0..*
Binding | The codes SHALL be taken from For example codes, see Laboratory Specialty http://hl7.org/fhir/ValueSet/document-classcodes|4.0.1 (required to `http://hl7.eu/fhir/laboratory/ValueSet/lab-specialty-eu-lab` )
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()))
42. Composition.subject
Definition | Who or what the composition is about. The composition can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure).
Short | Who and/or what the composition is about
Comments | DiagnosticReport and Composition SHALL have the same subject For clinical documents, this is usually the patient.
Control | 10..1
Type | Reference(Patient (EU core), Group, Location (EU core), Device, Resource)
Is Modifier | false
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()))
44. Composition.encounter
Definition | The healthcare event (e.g. a patient and healthcare provider interaction) which this DiagnosticReport is about. Describes the clinical encounter or type of care this documentation is associated with.
Short | The healthcare event which this Laboratory Report is about (when test ordered).Context of the Composition
Comments | This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests). DiagnosticReport and Composition SHALL have the same encounter.
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()))
46. Composition.date
Definition | The composition editing time, when the composition was last logically changed by the author.
Short | Composition 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
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()))
48. Composition.author
Definition | Identifies who is responsible for the information in the composition, not necessarily who typed it in.
Short | Who and/or what authored the composition
Comments | If a DiagnosticReport.resultsInterpreter exists this is expected to be a Composition.author; otherwise a DiagnosticReport.performer should be an author.
Control | 1..*
Type | Reference(Practitioner (EU core), PractitionerRole (EU core), Organization (EU core), Device, Patient (EU core), RelatedPerson, Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
Is Modifier | false
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()))
50. Composition.title
Definition | Official human-readable label for the composition. For this document should be "Laboratory Report" or any equivalent translation Official human-readable label for the composition.
Short | Laboratory ReportHuman 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
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
52. Composition.attester
Definition | A participant who has attested to the accuracy of the composition/document.
Short | Attests the report accuracyAttests to accuracy of composition
Comments | Only list each attester once.
Control | 0..*
Type | BackboneElement
Is Modifier | false
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()))
Slicing | This element introduces a set of slices on `Composition.attester`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ mode
54. 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())
56. 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
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()))
58. Composition.attester.time
Definition | When the composition was attested by the party.
Short | When the report was attested by the partyWhen 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
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()))
60. Composition.attester.party
Definition | Who attested the composition in the specified way.
Short | Who attested the reportWho attested the composition
Comments | For a Laboratory Report it is usually non expected that the attester would be a Patient or a RealtedPerson
Control | 0..1
Type | Reference(Patient (EU core), RelatedPerson, Practitioner (EU core), PractitionerRole (EU core), Organization (EU core), Patient, RelatedPerson, Practitioner, PractitionerRole, Organization)
Is Modifier | false
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()))
62. Composition.attester:legalAuthenticator
Slice Name | legalAuthenticator
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
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()))
64. Composition.attester:legalAuthenticator.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
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())
66. Composition.attester:legalAuthenticator.mode
Definition | The type of attestation the authenticator offers.
Short | personal | 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
Summary | false
Requirements | Indicates the level of authority of the attestation.
Pattern Value | `legal`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
68. Composition.attester:legalAuthenticator.time
Definition | When the composition was attested by the party.
Short | When the composition was attested
Control | 10..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
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()))
70. Composition.attester:legalAuthenticator.party
Definition | Who attested the composition in the specified way.
Short | Who attested the composition
Control | 10..1
Type | Reference(PractitionerRole (EU core), Practitioner (EU core), Patient, RelatedPerson, Practitioner, PractitionerRole, Organization)
Is Modifier | false
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()))
72. Composition.attester:validator
Slice Name | validator
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
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()))
74. Composition.attester:validator.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:validator.mode
Definition | The type of attestation the authenticator offers.
Short | personal | 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
Summary | false
Requirements | Indicates the level of authority of the attestation.
Pattern Value | `professional`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
78. Composition.attester:validator.time
Definition | When the composition was attested by the party.
Short | When the composition was attested
Control | 10..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
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:validator.party
Definition | Who attested the composition in the specified way.
Short | Who attested the composition
Control | 10..1
Type | Reference(PractitionerRole (EU core), Practitioner (EU core), Patient, RelatedPerson, Practitioner, PractitionerRole, Organization)
Is Modifier | false
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.event
Definition | The clinical service, such as a colonoscopy or an appendectomy, being documented.
Short | The laboratory service(s) being documentedThe 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
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()))
84. 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())
86. 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 laboratory service(s) being documentedCode(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
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
88. 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 | Period of time covered by the documentationThe period covered by the documentation
Control | 0..1
Type | Period
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
90. 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 laboratory service(s) being documentedThe 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()))
92. Composition.section
Definition | The "body" of the report is organized as a tree of up to two levels of sections: top level sections represent laboratory specialties. A top level section SHALL contain either one text block carrying all the text results produced for this specialty along with Laboratory Data Entries or a set of Laboratory Report Item Sections. In the first case the specialty section happens to also be a leaf section. In the latter case, each (second level) leaf section contained in the (top level) specialty section represents a Report Item: i.e., a battery, a specimen study (especially in microbiology), or an individual test. In addition, any leaf section SHALL contain a Laboratory Data Entries containing the observations of that section in a machine-readable format. The root of the sections that make up the composition.
Short | Composition is broken into sections
Control | 10..*
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())
Slicing | This element introduces a set of slices on `Composition.section`. The slices areUnordered and Open, and can be differentiated using the following discriminators: pattern @ $this.code
94. 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())
96. 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())
98. 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
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()))
100. 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
Is Modifier | false
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()))
102. 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
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
104. Composition.section:annotations
Slice Name | annotations
Definition | Narrative expression of comments accompanying the report, such as suggestions for evaluation, technical notes from the laboratory, etc. Examples: Suggestion: This result should be evaluated in relation to the patient's medical history and clinical condition. Technical note: A list of accredited examination(s) is available at www.laboratory.com. The root of the sections that make up the composition.
Short | Annotation commentComposition is broken into sections
Control | 0..*
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())
106. Composition.section:annotations.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:annotations.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:annotations.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
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:annotations.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
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "48767-8" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
114. Composition.section:annotations.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
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
116. Composition.section:annotations.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..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()))
118. Composition.section:annotations.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()))
120. Composition.section:attachment
Slice Name | attachment
Definition | A list of additional data associated with this report. This data is generally created during the diagnostic process, and may be directly of the patient, or of treated specimens (i.e. slides of interest). The root of the sections that make up the composition.
Short | Additional data (like images, diagrams) associated with this reportComposition is broken into sections
Control | 0..*
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())
122. Composition.section:attachment.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())
124. Composition.section:attachment.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())
126. Composition.section:attachment.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
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()))
128. Composition.section:attachment.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
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "77599-9" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
130. Composition.section:attachment.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
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
132. Composition.section:attachment.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 | 10..* This element is affected by the following invariants: cmp-2
Type | Reference(Binary, 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()))
134. Composition.section:attachment.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 | Laboratory Report composition. A composition is a set of healthcare-related information that is assembled together into a single logical document that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. While a Composition defines the structure, it does not actually contain the content: rather the full content of a document is contained in a Bundle, of which the Composition is the first resource contained.
Short | Laboratory Report composition
2. Composition.text
Short | Narrative text
4. Composition.extension:diagnosticReport
Slice Name | diagnosticReport
6. Composition.extension:diagnosticReport.value[x]
Control | 1..?
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
8. Composition.extension:diagnosticReport.value[x].reference
Comments | Added to the FHIR R4 guide to allow strictly conformance with the R4 rules for document bundle resources inclusion. Using this extension implies to accept a circular reference Composition to/from DiagnosticReport
Control | 1..?
10. Composition.identifier
Comments | Composition.identifier SHALL be equal to one of the DiagnosticReport.identifier, if at least one exists
Note | This is a business identifier, not a resource identifier (see discussion)
12. Composition.type
Definition | Specifies that it refers to a Laboratory Report
Short | Type of (Laboratory) Report
Comments | At least one DiagnosticReport.code.coding and Composition.type.coding SHALL be equal
Binding | The codes SHOULD be taken from Laboratory Report Types (preferred to `http://hl7.eu/fhir/laboratory/ValueSet/lab-reportType-eu-lab` )
14. Composition.category
Definition | A code that classifies this laboratory report. Two basic categories has been selected in this guide: laboratory specialty and Study type. Laboratory specialty is characteristic of the laboratory that produced the test result while Study type is an arbitrary classificion of the test type.
Short | Report Category
Comments | DiagnosticReport.category and Composition.category shall be aligned
Slicing | This element introduces a set of slices on `Composition.category`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ $this
16. Composition.category:studyType
Slice Name | studyType
Definition | Laboratory services, i.e., results of tests performed, could be characterized using typology of services, commonly called study types. Study type could be seen as an attribute or grouping mechanism that assigns a common clinical sense to certain types of laboratory test results., e.g., Hemoglobin, Platelet count, etc. belongs to 'Hematology study'.
Short | The way of grouping of the test results into clinically meaningful domains (e.g. hematology study, microbiology study, etc.)
Comments | In comparison to the laboratory specialty which is an attribute of laboratory, study type is a categorization of laboratory service. It needs to be mentioned that classification of test to study types in not standardized.
Control | 0..*
Binding | The codes SHALL be taken from Laboratory Study Types (required to `http://hl7.eu/fhir/laboratory/ValueSet/lab-studyType-eu-lab` )
18. Composition.category:specialty
Slice Name | specialty
Definition | Laboratory specialty is an attribute of any laboratory setting representing professional qualification of the laboratory to execute certain kind of laboratory tests.
Short | The clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry)
Comments | Specialty could be used as parameter for searching/querying of laboratory test results.
Control | 0..*
Binding | The codes SHALL be taken from Laboratory Specialty (required to `http://hl7.eu/fhir/laboratory/ValueSet/lab-specialty-eu-lab` )
20. Composition.subject
Comments | DiagnosticReport and Composition SHALL have the same subject
22. Composition.encounter
Definition | The healthcare event (e.g. a patient and healthcare provider interaction) which this DiagnosticReport is about.
Short | The healthcare event which this Laboratory Report is about (when test ordered).
Comments | This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests). DiagnosticReport and Composition SHALL have the same encounter.
24. Composition.author
Comments | If a DiagnosticReport.resultsInterpreter exists this is expected to be a Composition.author; otherwise a DiagnosticReport.performer should be an author.
26. Composition.title
Definition | Official human-readable label for the composition. For this document should be "Laboratory Report" or any equivalent translation
Short | Laboratory Report
28. Composition.attester
Short | Attests the report accuracy
30. Composition.attester.mode
Short | The type of attestation
32. Composition.attester.time
Short | When the report was attested by the party
34. Composition.attester.party
Short | Who attested the report
Comments | For a Laboratory Report it is usually non expected that the attester would be a Patient or a RealtedPerson
36. Composition.event
Short | The laboratory service(s) being documented
38. Composition.event.code
Short | Code(s) that apply to the laboratory service(s) being documented
40. Composition.event.period
Short | Period of time covered by the documentation
42. Composition.event.detail
Short | The laboratory service(s) being documented
44. Composition.section
Definition | The "body" of the report is organized as a tree of up to two levels of sections: top level sections represent laboratory specialties. A top level section SHALL contain either one text block carrying all the text results produced for this specialty along with Laboratory Data Entries or a set of Laboratory Report Item Sections. In the first case the specialty section happens to also be a leaf section. In the latter case, each (second level) leaf section contained in the (top level) specialty section represents a Report Item: i.e., a battery, a specimen study (especially in microbiology), or an individual test. In addition, any leaf section SHALL contain a Laboratory Data Entries containing the observations of that section in a machine-readable format.
Control | 1..?
Slicing | This element introduces a set of slices on `Composition.section`. The slices areUnordered and Open, and can be differentiated using the following discriminators: pattern @ $this.code
46. Composition.section:annotations
Slice Name | annotations
Definition | Narrative expression of comments accompanying the report, such as suggestions for evaluation, technical notes from the laboratory, etc. Examples: Suggestion: This result should be evaluated in relation to the patient's medical history and clinical condition. Technical note: A list of accredited examination(s) is available at www.laboratory.com.
Short | Annotation comment
Control | 0..*
48. Composition.section:annotations.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "48767-8" }] }`
50. Composition.section:annotations.entry
Control | 0..0
52. Composition.section:annotations.section
Control | 0..0
54. Composition.section:attachment
Slice Name | attachment
Definition | A list of additional data associated with this report. This data is generally created during the diagnostic process, and may be directly of the patient, or of treated specimens (i.e. slides of interest).
Short | Additional data (like images, diagrams) associated with this report
Control | 0..*
56. Composition.section:attachment.code
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "77599-9" }] }`
58. Composition.section:attachment.entry
Control | 1..?
Type | Reference(Binary, DocumentReference)
60. Composition.section:attachment.section
Control | 0..0

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

0. Composition
Definition | Laboratory Report composition. A composition is a set of healthcare-related information that is assembled together into a single logical document that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. While a Composition defines the structure, it does not actually contain the content: rather the full content of a document is contained in a Bundle, of which the Composition is the first resource contained.
Short | Laboratory Report composition
Comments | While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical.
Control | 0..*
Is Modifier | false
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.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())`)
8. Composition.language
Definition | The base language in which the resource is written.
Short | Language of the composition 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())`)
10. Composition.text
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Short | Narrative text
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
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())`)
12. Composition.contained
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
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
14. 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
16. Composition.extension:version
Slice Name | version
Definition | R5: `Composition.version` (new:string)
Short | R5: An explicitly assigned identifer of a variation of the content in the Composition (new)
Comments | Element `Composition.version` has a context of Composition based on following the parent source element upwards and mapping to `Composition`. Element `Composition.version` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). While each resource, including the composition itself, has its own version identifier, this is a formal identifier for the logical version of the Composition as a whole. It would remain constant if the resources were moved to a new server, and all got new individual resource versions, for example.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(R5: An explicitly assigned identifer of a variation of the content in the Composition (new)) (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()`)
18. Composition.extension:version.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
20. Composition.extension:version.extension
Definition | An Extension
Short | Extension
Control | 0..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.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
22. Composition.extension:version.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/5.0/StructureDefinition/extension-Composition.version`
24. Composition.extension:version.value[x]
Definition | An explicitly assigned identifer of a variation of the content in the Composition.
Short | An explicitly assigned identifer of a variation of the content in the Composition
Comments | While each resource, including the composition itself, has its own version identifier, this is a formal identifier for the logical version of the Composition as a whole. It would remain constant if the resources were moved to a new server, and all got new individual resource versions, for example.
Control | 0..1
Type | string
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
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.extension:informationRecipient
Slice Name | informationRecipient
Definition | This extension applies to the Composition resource and is used to represent an intended recipient of the composition.
Short | Composition: Information recipient
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(Composition: Information recipient) (Extension Type: Reference(Practitioner, Device, Patient, RelatedPerson, PractitionerRole, Organization, CareTeam, Group))
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()`)
28. Composition.extension:informationRecipient.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
30. Composition.extension:informationRecipient.extension
Definition | An Extension
Short | Extension
Control | 0..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.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
32. Composition.extension:informationRecipient.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.eu/fhir/StructureDefinition/information-recipient`
34. Composition.extension:informationRecipient.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 0..1
Type | Reference(Practitioner (EU core), PractitionerRole (EU core), Organization (EU core), Device, Patient (EU core), RelatedPerson)
[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())`)
36. Composition.extension:diagnosticReport
Slice Name | diagnosticReport
Definition | This extension provides a reference to the DiagnosticReport instance that is associated with this Composition.
Short | Document DiagnosticReport Reference
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Document DiagnosticReport Reference) (Extension Type: Reference(DiagnosticReport))
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()`)
38. Composition.extension:diagnosticReport.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
40. Composition.extension:diagnosticReport.extension
Definition | An Extension
Short | Extension
Control | 0..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.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
42. Composition.extension:diagnosticReport.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.eu/fhir/extensions/StructureDefinition/composition-diagnosticReportReference`
44. Composition.extension:diagnosticReport.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 1..1
Type | Reference(DiagnosticReport)
[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())`)
46. Composition.extension:diagnosticReport.value[x].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.extension:diagnosticReport.value[x].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.extension.value[x].extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
50. Composition.extension:diagnosticReport.value[x].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 | Added to the FHIR R4 guide to allow strictly conformance with the R4 rules for document bundle resources inclusion. Using this extension implies to accept a circular reference Composition to/from DiagnosticReport
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
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
52. Composition.extension:diagnosticReport.value[x].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.extension:diagnosticReport.value[x].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.extension:diagnosticReport.value[x].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.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()`)
60. Composition.identifier
Definition | Identifiers assigned to this document by the performer or other systems. Should remain stable across versions of the report.
Short | Report identifier
Comments | Composition.identifier SHALL be equal to one of the DiagnosticReport.identifier, if at least one exists
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 1..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())`)
62. Composition.status
Definition | The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.
Short | preliminary | 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 (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
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())`)
64. Composition.type
Definition | Specifies that it refers to a Laboratory Report
Short | Type of (Laboratory) Report
Comments | At least one DiagnosticReport.code.coding and Composition.type.coding SHALL be equal
Control | 1..1
Binding | The codes SHOULD be taken from Laboratory Report Types (preferred to `http://hl7.eu/fhir/laboratory/ValueSet/lab-reportType-eu-lab` )
Type | CodeableConcept
Is Modifier | false
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())`)
66. Composition.category
Definition | A code that classifies this laboratory report. Two basic categories has been selected in this guide: laboratory specialty and Study type. Laboratory specialty is characteristic of the laboratory that produced the test result while Study type is an arbitrary classificion of the test type.
Short | Report Category
Comments | DiagnosticReport.category and Composition.category shall be aligned
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())`)
Slicing | This element introduces a set of slices on `Composition.category`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ $this
68. Composition.category:studyType
Slice Name | studyType
Definition | Laboratory services, i.e., results of tests performed, could be characterized using typology of services, commonly called study types. Study type could be seen as an attribute or grouping mechanism that assigns a common clinical sense to certain types of laboratory test results., e.g., Hemoglobin, Platelet count, etc. belongs to 'Hematology study'.
Short | The way of grouping of the test results into clinically meaningful domains (e.g. hematology study, microbiology study, etc.)
Comments | In comparison to the laboratory specialty which is an attribute of laboratory, study type is a categorization of laboratory service. It needs to be mentioned that classification of test to study types in not standardized.
Control | 0..*
Binding | The codes SHALL be taken from Laboratory Study Types (required to `http://hl7.eu/fhir/laboratory/ValueSet/lab-studyType-eu-lab` )
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())`)
70. Composition.category:specialty
Slice Name | specialty
Definition | Laboratory specialty is an attribute of any laboratory setting representing professional qualification of the laboratory to execute certain kind of laboratory tests.
Short | The clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry)
Comments | Specialty could be used as parameter for searching/querying of laboratory test results.
Control | 0..*
Binding | The codes SHALL be taken from Laboratory Specialty (required to `http://hl7.eu/fhir/laboratory/ValueSet/lab-specialty-eu-lab` )
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())`)
72. Composition.subject
Definition | Who or what the composition is about. The composition can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure).
Short | Who and/or what the composition is about
Comments | DiagnosticReport and Composition SHALL have the same subject
Control | 1..1
Type | Reference(Patient (EU core), Group, Location (EU core), Device)
Is Modifier | false
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())`)
74. Composition.encounter
Definition | The healthcare event (e.g. a patient and healthcare provider interaction) which this DiagnosticReport is about.
Short | The healthcare event which this Laboratory Report is about (when test ordered).
Comments | This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests). DiagnosticReport and Composition SHALL have the same encounter.
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())`)
76. Composition.date
Definition | The composition editing time, when the composition was last logically changed by the author.
Short | Composition 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
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())`)
78. Composition.author
Definition | Identifies who is responsible for the information in the composition, not necessarily who typed it in.
Short | Who and/or what authored the composition
Comments | If a DiagnosticReport.resultsInterpreter exists this is expected to be a Composition.author; otherwise a DiagnosticReport.performer should be an author.
Control | 1..*
Type | Reference(Practitioner (EU core), PractitionerRole (EU core), Organization (EU core), Device, Patient (EU core), RelatedPerson)
Is Modifier | false
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())`)
80. Composition.title
Definition | Official human-readable label for the composition. For this document should be "Laboratory Report" or any equivalent translation
Short | Laboratory Report
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
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
82. 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())`)
84. Composition.attester
Definition | A participant who has attested to the accuracy of the composition/document.
Short | Attests the report accuracy
Comments | Only list each attester once.
Control | 0..*
Type | BackboneElement
Is Modifier | false
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())`)
Slicing | This element introduces a set of slices on `Composition.attester`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ mode
86. 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
88. 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()`)
90. 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()`)
92. 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
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())`)
94. Composition.attester.time
Definition | When the composition was attested by the party.
Short | When the report was attested by the party
Control | 0..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
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())`)
96. Composition.attester.party
Definition | Who attested the composition in the specified way.
Short | Who attested the report
Comments | For a Laboratory Report it is usually non expected that the attester would be a Patient or a RealtedPerson
Control | 0..1
Type | Reference(Patient (EU core), RelatedPerson, Practitioner (EU core), PractitionerRole (EU core), Organization (EU core))
Is Modifier | false
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())`)
98. Composition.attester:legalAuthenticator
Slice Name | legalAuthenticator
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
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())`)
100. Composition.attester:legalAuthenticator.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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
102. Composition.attester:legalAuthenticator.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
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()`)
104. Composition.attester:legalAuthenticator.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
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()`)
106. Composition.attester:legalAuthenticator.mode
Definition | The type of attestation the authenticator offers.
Short | personal | professional | legal | official
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
Summary | false
Requirements | Indicates the level of authority of the attestation.
Pattern Value | `legal`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
108. Composition.attester:legalAuthenticator.time
Definition | When the composition was attested by the party.
Short | When the composition was attested
Control | 1..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
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())`)
110. Composition.attester:legalAuthenticator.party
Definition | Who attested the composition in the specified way.
Short | Who attested the composition
Control | 1..1
Type | Reference(PractitionerRole (EU core), Practitioner (EU core))
Is Modifier | false
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())`)
112. Composition.attester:validator
Slice Name | validator
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
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())`)
114. Composition.attester:validator.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
116. Composition.attester:validator.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()`)
118. Composition.attester:validator.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.attester:validator.mode
Definition | The type of attestation the authenticator offers.
Short | personal | professional | legal | official
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
Summary | false
Requirements | Indicates the level of authority of the attestation.
Pattern Value | `professional`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
122. Composition.attester:validator.time
Definition | When the composition was attested by the party.
Short | When the composition was attested
Control | 1..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
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())`)
124. Composition.attester:validator.party
Definition | Who attested the composition in the specified way.
Short | Who attested the composition
Control | 1..1
Type | Reference(PractitionerRole (EU core), Practitioner (EU core))
Is Modifier | false
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())`)
126. Composition.custodian
Definition | Identifies the organization or group who is responsible for ongoing maintenance of and access to the composition/document information.
Short | Organization 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))
Is Modifier | false
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())`)
128. 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())`)
130. 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
132. 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()`)
134. 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()`)
136. 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())`)
138. 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())`)
140. Composition.event
Definition | The clinical service, such as a colonoscopy or an appendectomy, being documented.
Short | The laboratory 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
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())`)
142. 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
144. 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()`)
146. 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()`)
148. 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 laboratory service(s) 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
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
150. 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 | Period of time covered by the documentation
Control | 0..1
Type | Period
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
152. 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 laboratory service(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())`)
154. Composition.section
Definition | The "body" of the report is organized as a tree of up to two levels of sections: top level sections represent laboratory specialties. A top level section SHALL contain either one text block carrying all the text results produced for this specialty along with Laboratory Data Entries or a set of Laboratory Report Item Sections. In the first case the specialty section happens to also be a leaf section. In the latter case, each (second level) leaf section contained in the (top level) specialty section represents a Report Item: i.e., a battery, a specimen study (especially in microbiology), or an individual test. In addition, any leaf section SHALL contain a Laboratory Data Entries containing the observations of that section in a machine-readable format.
Short | Composition is broken into sections
Control | 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())`)
Slicing | This element introduces a set of slices on `Composition.section`. The slices areUnordered and Open, and can be differentiated using the following discriminators: pattern @ $this.code
156. 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
158. 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
160. 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()`)
162. 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()`)
164. 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
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())`)
166. 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
Is Modifier | false
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())`)
168. 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())`)
170. 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())`)
172. 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
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
174. 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())`)
176. 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())`)
178. 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())`)
180. 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 | Empty reason
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())`)
182. 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..* 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())`)
184. Composition.section:annotations
Slice Name | annotations
Definition | Narrative expression of comments accompanying the report, such as suggestions for evaluation, technical notes from the laboratory, etc. Examples: Suggestion: This result should be evaluated in relation to the patient's medical history and clinical condition. Technical note: A list of accredited examination(s) is available at www.laboratory.com.
Short | Annotation comment
Control | 0..*
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())`)
186. Composition.section:annotations.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
188. Composition.section:annotations.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
190. Composition.section:annotations.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()`)
192. Composition.section:annotations.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()`)
194. Composition.section:annotations.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
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())`)
196. Composition.section:annotations.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
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "48767-8" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
198. Composition.section:annotations.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())`)
200. Composition.section:annotations.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())`)
202. Composition.section:annotations.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
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
204. Composition.section:annotations.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())`)
206. Composition.section:annotations.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())`)
208. Composition.section:annotations.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..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())`)
210. Composition.section:annotations.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Empty reason
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())`)
212. Composition.section:annotations.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())`)
214. Composition.section:attachment
Slice Name | attachment
Definition | A list of additional data associated with this report. This data is generally created during the diagnostic process, and may be directly of the patient, or of treated specimens (i.e. slides of interest).
Short | Additional data (like images, diagrams) associated with this report
Control | 0..*
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())`)
216. Composition.section:attachment.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
218. Composition.section:attachment.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
220. Composition.section:attachment.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()`)
222. Composition.section:attachment.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()`)
224. Composition.section:attachment.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
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())`)
226. Composition.section:attachment.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
Is Modifier | false
Summary | false
Requirements | Provides computable standardized labels to topics within the document.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "77599-9" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
228. Composition.section:attachment.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())`)
230. Composition.section:attachment.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())`)
232. Composition.section:attachment.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
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
234. Composition.section:attachment.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())`)
236. Composition.section:attachment.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())`)
238. Composition.section:attachment.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 | 1..* This element is affected by the following invariants: cmp-2
Type | Reference(Binary, DocumentReference)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
240. Composition.section:attachment.emptyReason
Definition | If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.
Short | Empty reason
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())`)
242. Composition.section:attachment.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())`)