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: Composition: Laboratory Report

Official URL: http://hl7.eu/fhir/laboratory/StructureDefinition/Composition-eu-lab | Version: 2.0.0
Standards status: Trial-use | Maturity Level: 2 | Computable Name: CompositionLabReportEu
Copyright/Legal: Copyright HL7 Europe. Licensed under creative commons public domain (CC0 1.0).

Clinical document used to represent a Laboratory Report for the scope of the HL7 Europe project.

Usages:

- Use this Profile: Bundle: Laboratory Report
- Refer to this Profile: DiagnosticReport: Laboratory Report
- Examples for this Profile: Composition/comp-lab-example

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Composition |  | 0..* | CompositionEuCore | Laboratory Report composition
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
text |  | 0..1 | Narrative | Narrative text This profile does not constrain the narrative in regard to content, language, or traceability to data elements
Slices for extension |  |  |  | Content/Rules for all slices
extension:version |  | 0..1 | (Complex) | R5: An explicitly assigned identifer of a variation of the content in the Composition (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Composition.version Constraints: ext-1
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-Composition.version"
extension:informationRecipient |  | 0..* | (Complex) | Composition: Information recipient URL: http://hl7.eu/fhir/StructureDefinition/information-recipient
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.eu/fhir/StructureDefinition/information-recipient"
extension:diagnosticReport |  | 0..1 | (Complex) | Document DiagnosticReport Reference URL: http://hl7.eu/fhir/extensions/StructureDefinition/composition-diagnosticReportReference
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.eu/fhir/extensions/StructureDefinition/composition-diagnosticReportReference"
value[x] |  | 1..1 | Reference(DiagnosticReport) | Value of extension
reference | Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 1..1 | Identifier | Report identifier
status | ?!Σ | 1..1 | code | preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): The workflow/clinical status of the composition.
type | Σ | 1..1 | CodeableConcept | Type of (Laboratory) Report Binding: Laboratory Report Types (preferred)
Slices for category | Σ | 0..* | CodeableConcept | Report Category Slice: Unordered, Open by value:$this Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
category:studyType | Σ | 0..* | CodeableConcept | The way of grouping of the test results into clinically meaningful domains (e.g. hematology study, microbiology study, etc.) Binding: Laboratory Study Types (required)
category:specialty | Σ | 0..* | CodeableConcept | The clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry) Binding: Laboratory Specialty (required)
subject | Σ | 1..1 | Reference(Patient (EU core) | Group | Location (EU core) | Device) | Who and/or what the composition is about
encounter | Σ | 0..1 | Reference(Encounter) | The healthcare event which this Laboratory Report is about (when test ordered).
date | Σ | 1..1 | dateTime | Composition editing time
author | Σ | 1..* | Reference(Practitioner (EU core) | PractitionerRole (EU core) | Organization (EU core) | Device | Patient (EU core) | RelatedPerson) | Who and/or what authored the composition
title | Σ | 1..1 | string | Laboratory Report
Slices for attester |  | 0..* | BackboneElement | Attests the report accuracy Slice: Unordered, Open by value:mode
attester:All Slices |  |  |  | Content/Rules for all slices
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
mode |  | 1..1 | code | The type of attestation Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition.
time |  | 0..1 | dateTime | When the report was attested by the party
party |  | 0..1 | Reference(Patient (EU core) | RelatedPerson | Practitioner (EU core) | PractitionerRole (EU core) | Organization (EU core)) | Who attested the report
attester:legalAuthenticator |  | 0..* | BackboneElement | Attests to accuracy of composition
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
mode |  | 1..1 | code | personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. Required Pattern: legal
time |  | 1..1 | dateTime | When the composition was attested
party |  | 1..1 | Reference(PractitionerRole (EU core) | Practitioner (EU core)) | Who attested the composition
attester:validator |  | 0..* | BackboneElement | Attests to accuracy of composition
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
mode |  | 1..1 | code | personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. Required Pattern: professional
time |  | 1..1 | dateTime | When the composition was attested
party |  | 1..1 | Reference(PractitionerRole (EU core) | Practitioner (EU core)) | Who attested the composition
event | Σ | 0..* | BackboneElement | The laboratory service(s) being documented
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 0..* | CodeableConcept | Code(s) that apply to the laboratory service(s) being documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.
period | Σ | 0..1 | Period | Period of time covered by the documentation
detail | Σ | 0..* | Reference(Resource) | The laboratory service(s) being documented
Slices for section | C | 1..* | BackboneElement | Composition is broken into sections Slice: Unordered, Open by pattern:$this.code Constraints: cmp-1, cmp-2
section:All Slices |  |  |  | Content/Rules for all slices
Slices for extension |  |  |  | Content/Rules for all slices
extension:section-note |  | 0..* | Annotation | Additional notes that apply to the section (but not to specific resource). URL: http://hl7.org/fhir/StructureDefinition/note
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title |  | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
text | C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
section:annotations | C | 0..* | BackboneElement | Annotation comment Constraints: cmp-1, cmp-2
Slices for extension |  |  |  | Content/Rules for all slices
extension:section-note |  | 0..* | Annotation | Additional notes that apply to the section (but not to specific resource). URL: http://hl7.org/fhir/StructureDefinition/note
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title |  | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 48767-8
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
text | C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
section:attachment | C | 0..* | BackboneElement | Additional data (like images, diagrams) associated with this report Constraints: cmp-1, cmp-2
Slices for extension |  |  |  | Content/Rules for all slices
extension:section-note |  | 0..* | Annotation | Additional notes that apply to the section (but not to specific resource). URL: http://hl7.org/fhir/StructureDefinition/note
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title |  | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 77599-9
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
text | C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
entry | C | 1..* | Reference(Binary | DocumentReference) | A reference to data that supports this section
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Composition.status | Base | required | CompositionStatus | 📍4.0.1 | FHIR Std.
Composition.type | Base | preferred | Laboratory Report Types | 📦2.0.0 | This IG
Composition.category | Base | example | Document Class Value Set | 📍4.0.1 | FHIR Std.
Composition.category:studyType | Base | required | Laboratory Study Types | 📦2.0.0 | This IG
Composition.category:specialty | Base | required | Laboratory Specialty | 📦2.0.0 | This IG
Composition.attester.​mode | Base | required | CompositionAttestationMode | 📍4.0.1 | FHIR Std.
Composition.attester:legalAuthenticator.​mode | Base | required | CompositionAttestationMode | 📍4.0.1 | FHIR Std.
Composition.attester:validator.​mode | Base | required | CompositionAttestationMode | 📍4.0.1 | FHIR Std.
Composition.event.code | Base | example | v3 Code System ActCode | 📦3.0.0 | THO v7.1
Composition.section.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:annotations.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:attachment.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
cmp-1 | error | Composition.section, Composition.section:annotations, Composition.section:attachment | A section must contain at least one of text, entries, or sub-sections | `text.exists() or entry.exists() or section.exists()`
cmp-2 | error | Composition.section, Composition.section:annotations, Composition.section:attachment | A section can only have an emptyReason if it is empty | `emptyReason.empty() or entry.empty()`
dom-2 | error | Composition | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Composition | 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 | error | Composition | 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 | error | Composition | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Composition | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | Composition.extension:version, Composition.extension:informationRecipient, Composition.extension:diagnosticReport, Composition.modifierExtension, Composition.attester.modifierExtension, Composition.attester:legalAuthenticator.modifierExtension, Composition.attester:validator.modifierExtension, Composition.event.modifierExtension, Composition.section.extension:section-note, Composition.section.modifierExtension, Composition.section:annotations.extension:section-note, Composition.section:annotations.modifierExtension, Composition.section:attachment.extension:section-note, Composition.section:attachment.modifierExtension | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from CompositionEuCore

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Composition |  | 0..* | CompositionEuCore | Laboratory Report composition
text |  | 0..1 | Narrative | Narrative text
Slices for extension |  |  |  | Content/Rules for all slices
extension:diagnosticReport |  | 0..1 | DiagnosticReportReference | Document DiagnosticReport Reference
value[x] |  | 1..1 | Reference(DiagnosticReport) | Value of extension
reference |  | 1..1 | string | Literal reference, Relative, internal or absolute URL
identifier |  | 1..1 | Identifier | Report identifier
type |  | 1..1 | CodeableConcept | Type of (Laboratory) Report Binding: Laboratory Report Types (preferred)
Slices for category |  | 0..* | CodeableConcept | Report Category Slice: Unordered, Open by value:$this
category:studyType |  | 0..* | CodeableConcept | The way of grouping of the test results into clinically meaningful domains (e.g. hematology study, microbiology study, etc.) Binding: Laboratory Study Types (required)
category:specialty |  | 0..* | CodeableConcept | The clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry) Binding: Laboratory Specialty (required)
subject |  | 1..1 | Reference(Patient (EU core) | Group | Location (EU core) | Device) | Who and/or what the composition is about
encounter |  | 0..1 | Reference(Encounter) | The healthcare event which this Laboratory Report is about (when test ordered).
author |  | 1..* | Reference(Practitioner (EU core) | PractitionerRole (EU core) | Organization (EU core) | Device | Patient (EU core) | RelatedPerson) | Who and/or what authored the composition
title |  | 1..1 | string | Laboratory Report
attester |  | 0..* | BackboneElement | Attests the report accuracy
mode |  | 1..1 | code | The type of attestation
time |  | 0..1 | dateTime | When the report was attested by the party
party |  | 0..1 | Reference(Patient (EU core) | RelatedPerson | Practitioner (EU core) | PractitionerRole (EU core) | Organization (EU core)) | Who attested the report
event |  | 0..* | BackboneElement | The laboratory service(s) being documented
code |  | 0..* | CodeableConcept | Code(s) that apply to the laboratory service(s) being documented
period |  | 0..1 | Period | Period of time covered by the documentation
detail |  | 0..* | Reference(Resource) | The laboratory service(s) being documented
Slices for section |  | 1..* | BackboneElement | Composition is broken into sections Slice: Unordered, Open by pattern:$this.code
section:annotations |  | 0..* | BackboneElement | Annotation comment
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 48767-8
entry |  | 0..0 |  | A reference to data that supports this section
section |  | 0..0 |  | Nested Section
section:attachment |  | 0..* | BackboneElement | Additional data (like images, diagrams) associated with this report
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 77599-9
entry |  | 1..* | Reference(Binary | DocumentReference) | A reference to data that supports this section
section |  | 0..0 |  | Nested Section
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Composition.type | Base | preferred | Laboratory Report Types | 📦2.0.0 | This IG
Composition.category:studyType | Base | required | Laboratory Study Types | 📦2.0.0 | This IG
Composition.category:specialty | Base | required | Laboratory Specialty | 📦2.0.0 | This IG

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Composition |  | 0..* | CompositionEuCore | Laboratory Report composition
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the composition content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Narrative text This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:version |  | 0..1 | (Complex) | R5: An explicitly assigned identifer of a variation of the content in the Composition (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Composition.version Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-Composition.version"
value[x] |  | 0..1 | string | An explicitly assigned identifer of a variation of the content in the Composition
extension:informationRecipient |  | 0..* | (Complex) | Composition: Information recipient URL: http://hl7.eu/fhir/StructureDefinition/information-recipient
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.eu/fhir/StructureDefinition/information-recipient"
value[x] |  | 0..1 | Reference(Practitioner (EU core) | PractitionerRole (EU core) | Organization (EU core) | Device | Patient (EU core) | RelatedPerson) | Value of extension
extension:diagnosticReport |  | 0..1 | (Complex) | Document DiagnosticReport Reference URL: http://hl7.eu/fhir/extensions/StructureDefinition/composition-diagnosticReportReference
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.eu/fhir/extensions/StructureDefinition/composition-diagnosticReportReference"
value[x] |  | 1..1 | Reference(DiagnosticReport) | Value of extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 1..1 | Identifier | Report identifier
status | ?!Σ | 1..1 | code | preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): The workflow/clinical status of the composition.
type | Σ | 1..1 | CodeableConcept | Type of (Laboratory) Report Binding: Laboratory Report Types (preferred)
Slices for category | Σ | 0..* | CodeableConcept | Report Category Slice: Unordered, Open by value:$this Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
category:studyType | Σ | 0..* | CodeableConcept | The way of grouping of the test results into clinically meaningful domains (e.g. hematology study, microbiology study, etc.) Binding: Laboratory Study Types (required)
category:specialty | Σ | 0..* | CodeableConcept | The clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry) Binding: Laboratory Specialty (required)
subject | Σ | 1..1 | Reference(Patient (EU core) | Group | Location (EU core) | Device) | Who and/or what the composition is about
encounter | Σ | 0..1 | Reference(Encounter) | The healthcare event which this Laboratory Report is about (when test ordered).
date | Σ | 1..1 | dateTime | Composition editing time
author | Σ | 1..* | Reference(Practitioner (EU core) | PractitionerRole (EU core) | Organization (EU core) | Device | Patient (EU core) | RelatedPerson) | Who and/or what authored the composition
title | Σ | 1..1 | string | Laboratory Report
confidentiality | Σ | 0..1 | code | As defined by affinity domain Binding: v3.ConfidentialityClassification (2014-03-26) (required): Codes specifying the level of confidentiality of the composition.
Slices for attester |  | 0..* | BackboneElement | Attests the report accuracy Slice: Unordered, Open by value:mode
attester:All Slices |  |  |  | Content/Rules for all slices
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
mode |  | 1..1 | code | The type of attestation Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition.
time |  | 0..1 | dateTime | When the report was attested by the party
party |  | 0..1 | Reference(Patient (EU core) | RelatedPerson | Practitioner (EU core) | PractitionerRole (EU core) | Organization (EU core)) | Who attested the report
attester:legalAuthenticator |  | 0..* | BackboneElement | Attests to accuracy of composition
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
mode |  | 1..1 | code | personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. Required Pattern: legal
time |  | 1..1 | dateTime | When the composition was attested
party |  | 1..1 | Reference(PractitionerRole (EU core) | Practitioner (EU core)) | Who attested the composition
attester:validator |  | 0..* | BackboneElement | Attests to accuracy of composition
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
mode |  | 1..1 | code | personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. Required Pattern: professional
time |  | 1..1 | dateTime | When the composition was attested
party |  | 1..1 | Reference(PractitionerRole (EU core) | Practitioner (EU core)) | Who attested the composition
custodian | Σ | 0..1 | Reference(Organization (EU core)) | Organization which maintains the composition
relatesTo |  | 0..* | BackboneElement | Relationships to other compositions/documents
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code |  | 1..1 | code | replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target[x] |  | 1..1 |  | Target of the relationship
targetIdentifier |  |  | Identifier |
targetReference |  |  | Reference(Composition) |
event | Σ | 0..* | BackboneElement | The laboratory service(s) being documented
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 0..* | CodeableConcept | Code(s) that apply to the laboratory service(s) being documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.
period | Σ | 0..1 | Period | Period of time covered by the documentation
detail | Σ | 0..* | Reference(Resource) | The laboratory service(s) being documented
Slices for section | C | 1..* | BackboneElement | Composition is broken into sections Slice: Unordered, Open by pattern:$this.code Constraints: cmp-1, cmp-2
section:All Slices |  |  |  | Content/Rules for all slices
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:section-note |  | 0..* | Annotation | Additional notes that apply to the section (but not to specific resource). URL: http://hl7.org/fhir/StructureDefinition/note
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title |  | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
author |  | 0..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the section
focus |  | 0..1 | Reference(Resource) | Who/what the section is about, when it is not about the subject of composition
text | C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode |  | 0..1 | code | working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy |  | 0..1 | CodeableConcept | Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry | C | 0..* | Reference(Resource) | A reference to data that supports this section
emptyReason | C | 0..1 | CodeableConcept | Empty reason Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section | C | 0..* | See section (Composition) | Nested Section
section:annotations | C | 0..* | BackboneElement | Annotation comment Constraints: cmp-1, cmp-2
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:section-note |  | 0..* | Annotation | Additional notes that apply to the section (but not to specific resource). URL: http://hl7.org/fhir/StructureDefinition/note
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title |  | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 48767-8
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
author |  | 0..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the section
focus |  | 0..1 | Reference(Resource) | Who/what the section is about, when it is not about the subject of composition
text | C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode |  | 0..1 | code | working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy |  | 0..1 | CodeableConcept | Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
emptyReason | C | 0..1 | CodeableConcept | Empty reason Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section:attachment | C | 0..* | BackboneElement | Additional data (like images, diagrams) associated with this report Constraints: cmp-1, cmp-2
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:section-note |  | 0..* | Annotation | Additional notes that apply to the section (but not to specific resource). URL: http://hl7.org/fhir/StructureDefinition/note
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title |  | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 77599-9
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
author |  | 0..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the section
focus |  | 0..1 | Reference(Resource) | Who/what the section is about, when it is not about the subject of composition
text | C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode |  | 0..1 | code | working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy |  | 0..1 | CodeableConcept | Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry | C | 1..* | Reference(Binary | DocumentReference) | A reference to data that supports this section
emptyReason | C | 0..1 | CodeableConcept | Empty reason Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Composition.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Composition.extension:diagnosticReport.​value[x].type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
Composition.status | Base | required | CompositionStatus | 📍4.0.1 | FHIR Std.
Composition.type | Base | preferred | Laboratory Report Types | 📦2.0.0 | This IG
Composition.category | Base | example | Document Class Value Set | 📍4.0.1 | FHIR Std.
Composition.category:studyType | Base | required | Laboratory Study Types | 📦2.0.0 | This IG
Composition.category:specialty | Base | required | Laboratory Specialty | 📦2.0.0 | This IG
Composition.confidentiality | Base | required | V3 Value SetConfidentialityClassification | 📍2014-03-26 | FHIR Std.
Composition.attester.​mode | Base | required | CompositionAttestationMode | 📍4.0.1 | FHIR Std.
Composition.attester:legalAuthenticator.​mode | Base | required | CompositionAttestationMode | 📍4.0.1 | FHIR Std.
Composition.attester:validator.​mode | Base | required | CompositionAttestationMode | 📍4.0.1 | FHIR Std.
Composition.relatesTo.​code | Base | required | DocumentRelationshipType | 📍4.0.1 | FHIR Std.
Composition.event.code | Base | example | v3 Code System ActCode | 📦3.0.0 | THO v7.1
Composition.section.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:annotations.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:annotations.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:annotations.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:annotations.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:attachment.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:attachment.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:attachment.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:attachment.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
cmp-1 | error | Composition.section, Composition.section:annotations, Composition.section:attachment | A section must contain at least one of text, entries, or sub-sections | `text.exists() or entry.exists() or section.exists()`
cmp-2 | error | Composition.section, Composition.section:annotations, Composition.section:attachment | A section can only have an emptyReason if it is empty | `emptyReason.empty() or entry.empty()`
dom-2 | error | Composition | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Composition | 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 | error | Composition | 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 | error | Composition | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Composition | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from CompositionEuCore

Summary

Mandatory: 1 element(3 nested mandatory elements)
Prohibited: 3 elements

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Composition.category
- The element 1 is sliced based on the value of Composition.section

Maturity: 2

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Composition |  | 0..* | CompositionEuCore | Laboratory Report composition
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
text |  | 0..1 | Narrative | Narrative text This profile does not constrain the narrative in regard to content, language, or traceability to data elements
Slices for extension |  |  |  | Content/Rules for all slices
extension:version |  | 0..1 | (Complex) | R5: An explicitly assigned identifer of a variation of the content in the Composition (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Composition.version Constraints: ext-1
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-Composition.version"
extension:informationRecipient |  | 0..* | (Complex) | Composition: Information recipient URL: http://hl7.eu/fhir/StructureDefinition/information-recipient
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.eu/fhir/StructureDefinition/information-recipient"
extension:diagnosticReport |  | 0..1 | (Complex) | Document DiagnosticReport Reference URL: http://hl7.eu/fhir/extensions/StructureDefinition/composition-diagnosticReportReference
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.eu/fhir/extensions/StructureDefinition/composition-diagnosticReportReference"
value[x] |  | 1..1 | Reference(DiagnosticReport) | Value of extension
reference | Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 1..1 | Identifier | Report identifier
status | ?!Σ | 1..1 | code | preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): The workflow/clinical status of the composition.
type | Σ | 1..1 | CodeableConcept | Type of (Laboratory) Report Binding: Laboratory Report Types (preferred)
Slices for category | Σ | 0..* | CodeableConcept | Report Category Slice: Unordered, Open by value:$this Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
category:studyType | Σ | 0..* | CodeableConcept | The way of grouping of the test results into clinically meaningful domains (e.g. hematology study, microbiology study, etc.) Binding: Laboratory Study Types (required)
category:specialty | Σ | 0..* | CodeableConcept | The clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry) Binding: Laboratory Specialty (required)
subject | Σ | 1..1 | Reference(Patient (EU core) | Group | Location (EU core) | Device) | Who and/or what the composition is about
encounter | Σ | 0..1 | Reference(Encounter) | The healthcare event which this Laboratory Report is about (when test ordered).
date | Σ | 1..1 | dateTime | Composition editing time
author | Σ | 1..* | Reference(Practitioner (EU core) | PractitionerRole (EU core) | Organization (EU core) | Device | Patient (EU core) | RelatedPerson) | Who and/or what authored the composition
title | Σ | 1..1 | string | Laboratory Report
Slices for attester |  | 0..* | BackboneElement | Attests the report accuracy Slice: Unordered, Open by value:mode
attester:All Slices |  |  |  | Content/Rules for all slices
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
mode |  | 1..1 | code | The type of attestation Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition.
time |  | 0..1 | dateTime | When the report was attested by the party
party |  | 0..1 | Reference(Patient (EU core) | RelatedPerson | Practitioner (EU core) | PractitionerRole (EU core) | Organization (EU core)) | Who attested the report
attester:legalAuthenticator |  | 0..* | BackboneElement | Attests to accuracy of composition
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
mode |  | 1..1 | code | personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. Required Pattern: legal
time |  | 1..1 | dateTime | When the composition was attested
party |  | 1..1 | Reference(PractitionerRole (EU core) | Practitioner (EU core)) | Who attested the composition
attester:validator |  | 0..* | BackboneElement | Attests to accuracy of composition
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
mode |  | 1..1 | code | personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. Required Pattern: professional
time |  | 1..1 | dateTime | When the composition was attested
party |  | 1..1 | Reference(PractitionerRole (EU core) | Practitioner (EU core)) | Who attested the composition
event | Σ | 0..* | BackboneElement | The laboratory service(s) being documented
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 0..* | CodeableConcept | Code(s) that apply to the laboratory service(s) being documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.
period | Σ | 0..1 | Period | Period of time covered by the documentation
detail | Σ | 0..* | Reference(Resource) | The laboratory service(s) being documented
Slices for section | C | 1..* | BackboneElement | Composition is broken into sections Slice: Unordered, Open by pattern:$this.code Constraints: cmp-1, cmp-2
section:All Slices |  |  |  | Content/Rules for all slices
Slices for extension |  |  |  | Content/Rules for all slices
extension:section-note |  | 0..* | Annotation | Additional notes that apply to the section (but not to specific resource). URL: http://hl7.org/fhir/StructureDefinition/note
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title |  | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
text | C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
section:annotations | C | 0..* | BackboneElement | Annotation comment Constraints: cmp-1, cmp-2
Slices for extension |  |  |  | Content/Rules for all slices
extension:section-note |  | 0..* | Annotation | Additional notes that apply to the section (but not to specific resource). URL: http://hl7.org/fhir/StructureDefinition/note
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title |  | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 48767-8
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
text | C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
section:attachment | C | 0..* | BackboneElement | Additional data (like images, diagrams) associated with this report Constraints: cmp-1, cmp-2
Slices for extension |  |  |  | Content/Rules for all slices
extension:section-note |  | 0..* | Annotation | Additional notes that apply to the section (but not to specific resource). URL: http://hl7.org/fhir/StructureDefinition/note
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title |  | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 77599-9
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
text | C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
entry | C | 1..* | Reference(Binary | DocumentReference) | A reference to data that supports this section
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Composition.status | Base | required | CompositionStatus | 📍4.0.1 | FHIR Std.
Composition.type | Base | preferred | Laboratory Report Types | 📦2.0.0 | This IG
Composition.category | Base | example | Document Class Value Set | 📍4.0.1 | FHIR Std.
Composition.category:studyType | Base | required | Laboratory Study Types | 📦2.0.0 | This IG
Composition.category:specialty | Base | required | Laboratory Specialty | 📦2.0.0 | This IG
Composition.attester.​mode | Base | required | CompositionAttestationMode | 📍4.0.1 | FHIR Std.
Composition.attester:legalAuthenticator.​mode | Base | required | CompositionAttestationMode | 📍4.0.1 | FHIR Std.
Composition.attester:validator.​mode | Base | required | CompositionAttestationMode | 📍4.0.1 | FHIR Std.
Composition.event.code | Base | example | v3 Code System ActCode | 📦3.0.0 | THO v7.1
Composition.section.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:annotations.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:attachment.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
cmp-1 | error | Composition.section, Composition.section:annotations, Composition.section:attachment | A section must contain at least one of text, entries, or sub-sections | `text.exists() or entry.exists() or section.exists()`
cmp-2 | error | Composition.section, Composition.section:annotations, Composition.section:attachment | A section can only have an emptyReason if it is empty | `emptyReason.empty() or entry.empty()`
dom-2 | error | Composition | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Composition | 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 | error | Composition | 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 | error | Composition | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Composition | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | Composition.extension:version, Composition.extension:informationRecipient, Composition.extension:diagnosticReport, Composition.modifierExtension, Composition.attester.modifierExtension, Composition.attester:legalAuthenticator.modifierExtension, Composition.attester:validator.modifierExtension, Composition.event.modifierExtension, Composition.section.extension:section-note, Composition.section.modifierExtension, Composition.section:annotations.extension:section-note, Composition.section:annotations.modifierExtension, Composition.section:attachment.extension:section-note, Composition.section:attachment.modifierExtension | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Differential View

This structure is derived from CompositionEuCore

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Composition |  | 0..* | CompositionEuCore | Laboratory Report composition
text |  | 0..1 | Narrative | Narrative text
Slices for extension |  |  |  | Content/Rules for all slices
extension:diagnosticReport |  | 0..1 | DiagnosticReportReference | Document DiagnosticReport Reference
value[x] |  | 1..1 | Reference(DiagnosticReport) | Value of extension
reference |  | 1..1 | string | Literal reference, Relative, internal or absolute URL
identifier |  | 1..1 | Identifier | Report identifier
type |  | 1..1 | CodeableConcept | Type of (Laboratory) Report Binding: Laboratory Report Types (preferred)
Slices for category |  | 0..* | CodeableConcept | Report Category Slice: Unordered, Open by value:$this
category:studyType |  | 0..* | CodeableConcept | The way of grouping of the test results into clinically meaningful domains (e.g. hematology study, microbiology study, etc.) Binding: Laboratory Study Types (required)
category:specialty |  | 0..* | CodeableConcept | The clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry) Binding: Laboratory Specialty (required)
subject |  | 1..1 | Reference(Patient (EU core) | Group | Location (EU core) | Device) | Who and/or what the composition is about
encounter |  | 0..1 | Reference(Encounter) | The healthcare event which this Laboratory Report is about (when test ordered).
author |  | 1..* | Reference(Practitioner (EU core) | PractitionerRole (EU core) | Organization (EU core) | Device | Patient (EU core) | RelatedPerson) | Who and/or what authored the composition
title |  | 1..1 | string | Laboratory Report
attester |  | 0..* | BackboneElement | Attests the report accuracy
mode |  | 1..1 | code | The type of attestation
time |  | 0..1 | dateTime | When the report was attested by the party
party |  | 0..1 | Reference(Patient (EU core) | RelatedPerson | Practitioner (EU core) | PractitionerRole (EU core) | Organization (EU core)) | Who attested the report
event |  | 0..* | BackboneElement | The laboratory service(s) being documented
code |  | 0..* | CodeableConcept | Code(s) that apply to the laboratory service(s) being documented
period |  | 0..1 | Period | Period of time covered by the documentation
detail |  | 0..* | Reference(Resource) | The laboratory service(s) being documented
Slices for section |  | 1..* | BackboneElement | Composition is broken into sections Slice: Unordered, Open by pattern:$this.code
section:annotations |  | 0..* | BackboneElement | Annotation comment
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 48767-8
entry |  | 0..0 |  | A reference to data that supports this section
section |  | 0..0 |  | Nested Section
section:attachment |  | 0..* | BackboneElement | Additional data (like images, diagrams) associated with this report
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 77599-9
entry |  | 1..* | Reference(Binary | DocumentReference) | A reference to data that supports this section
section |  | 0..0 |  | Nested Section
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Composition.type | Base | preferred | Laboratory Report Types | 📦2.0.0 | This IG
Composition.category:studyType | Base | required | Laboratory Study Types | 📦2.0.0 | This IG
Composition.category:specialty | Base | required | Laboratory Specialty | 📦2.0.0 | This IG

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Composition |  | 0..* | CompositionEuCore | Laboratory Report composition
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the composition content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Narrative text This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:version |  | 0..1 | (Complex) | R5: An explicitly assigned identifer of a variation of the content in the Composition (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Composition.version Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-Composition.version"
value[x] |  | 0..1 | string | An explicitly assigned identifer of a variation of the content in the Composition
extension:informationRecipient |  | 0..* | (Complex) | Composition: Information recipient URL: http://hl7.eu/fhir/StructureDefinition/information-recipient
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.eu/fhir/StructureDefinition/information-recipient"
value[x] |  | 0..1 | Reference(Practitioner (EU core) | PractitionerRole (EU core) | Organization (EU core) | Device | Patient (EU core) | RelatedPerson) | Value of extension
extension:diagnosticReport |  | 0..1 | (Complex) | Document DiagnosticReport Reference URL: http://hl7.eu/fhir/extensions/StructureDefinition/composition-diagnosticReportReference
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.eu/fhir/extensions/StructureDefinition/composition-diagnosticReportReference"
value[x] |  | 1..1 | Reference(DiagnosticReport) | Value of extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
reference | Σ C | 1..1 | string | Literal reference, Relative, internal or absolute URL
type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known
display | Σ | 0..1 | string | Text alternative for the resource
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 1..1 | Identifier | Report identifier
status | ?!Σ | 1..1 | code | preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): The workflow/clinical status of the composition.
type | Σ | 1..1 | CodeableConcept | Type of (Laboratory) Report Binding: Laboratory Report Types (preferred)
Slices for category | Σ | 0..* | CodeableConcept | Report Category Slice: Unordered, Open by value:$this Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
category:studyType | Σ | 0..* | CodeableConcept | The way of grouping of the test results into clinically meaningful domains (e.g. hematology study, microbiology study, etc.) Binding: Laboratory Study Types (required)
category:specialty | Σ | 0..* | CodeableConcept | The clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry) Binding: Laboratory Specialty (required)
subject | Σ | 1..1 | Reference(Patient (EU core) | Group | Location (EU core) | Device) | Who and/or what the composition is about
encounter | Σ | 0..1 | Reference(Encounter) | The healthcare event which this Laboratory Report is about (when test ordered).
date | Σ | 1..1 | dateTime | Composition editing time
author | Σ | 1..* | Reference(Practitioner (EU core) | PractitionerRole (EU core) | Organization (EU core) | Device | Patient (EU core) | RelatedPerson) | Who and/or what authored the composition
title | Σ | 1..1 | string | Laboratory Report
confidentiality | Σ | 0..1 | code | As defined by affinity domain Binding: v3.ConfidentialityClassification (2014-03-26) (required): Codes specifying the level of confidentiality of the composition.
Slices for attester |  | 0..* | BackboneElement | Attests the report accuracy Slice: Unordered, Open by value:mode
attester:All Slices |  |  |  | Content/Rules for all slices
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
mode |  | 1..1 | code | The type of attestation Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition.
time |  | 0..1 | dateTime | When the report was attested by the party
party |  | 0..1 | Reference(Patient (EU core) | RelatedPerson | Practitioner (EU core) | PractitionerRole (EU core) | Organization (EU core)) | Who attested the report
attester:legalAuthenticator |  | 0..* | BackboneElement | Attests to accuracy of composition
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
mode |  | 1..1 | code | personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. Required Pattern: legal
time |  | 1..1 | dateTime | When the composition was attested
party |  | 1..1 | Reference(PractitionerRole (EU core) | Practitioner (EU core)) | Who attested the composition
attester:validator |  | 0..* | BackboneElement | Attests to accuracy of composition
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
mode |  | 1..1 | code | personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. Required Pattern: professional
time |  | 1..1 | dateTime | When the composition was attested
party |  | 1..1 | Reference(PractitionerRole (EU core) | Practitioner (EU core)) | Who attested the composition
custodian | Σ | 0..1 | Reference(Organization (EU core)) | Organization which maintains the composition
relatesTo |  | 0..* | BackboneElement | Relationships to other compositions/documents
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code |  | 1..1 | code | replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target[x] |  | 1..1 |  | Target of the relationship
targetIdentifier |  |  | Identifier |
targetReference |  |  | Reference(Composition) |
event | Σ | 0..* | BackboneElement | The laboratory service(s) being documented
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 0..* | CodeableConcept | Code(s) that apply to the laboratory service(s) being documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.
period | Σ | 0..1 | Period | Period of time covered by the documentation
detail | Σ | 0..* | Reference(Resource) | The laboratory service(s) being documented
Slices for section | C | 1..* | BackboneElement | Composition is broken into sections Slice: Unordered, Open by pattern:$this.code Constraints: cmp-1, cmp-2
section:All Slices |  |  |  | Content/Rules for all slices
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:section-note |  | 0..* | Annotation | Additional notes that apply to the section (but not to specific resource). URL: http://hl7.org/fhir/StructureDefinition/note
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title |  | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
author |  | 0..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the section
focus |  | 0..1 | Reference(Resource) | Who/what the section is about, when it is not about the subject of composition
text | C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode |  | 0..1 | code | working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy |  | 0..1 | CodeableConcept | Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry | C | 0..* | Reference(Resource) | A reference to data that supports this section
emptyReason | C | 0..1 | CodeableConcept | Empty reason Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section | C | 0..* | See section (Composition) | Nested Section
section:annotations | C | 0..* | BackboneElement | Annotation comment Constraints: cmp-1, cmp-2
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:section-note |  | 0..* | Annotation | Additional notes that apply to the section (but not to specific resource). URL: http://hl7.org/fhir/StructureDefinition/note
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title |  | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 48767-8
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
author |  | 0..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the section
focus |  | 0..1 | Reference(Resource) | Who/what the section is about, when it is not about the subject of composition
text | C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode |  | 0..1 | code | working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy |  | 0..1 | CodeableConcept | Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
emptyReason | C | 0..1 | CodeableConcept | Empty reason Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section:attachment | C | 0..* | BackboneElement | Additional data (like images, diagrams) associated with this report Constraints: cmp-1, cmp-2
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:section-note |  | 0..* | Annotation | Additional notes that apply to the section (but not to specific resource). URL: http://hl7.org/fhir/StructureDefinition/note
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title |  | 1..1 | string | Label for section (e.g. for ToC)
code |  | 1..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 77599-9
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
author |  | 0..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the section
focus |  | 0..1 | Reference(Resource) | Who/what the section is about, when it is not about the subject of composition
text | C | 1..1 | Narrative | Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode |  | 0..1 | code | working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy |  | 0..1 | CodeableConcept | Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry | C | 1..* | Reference(Binary | DocumentReference) | A reference to data that supports this section
emptyReason | C | 0..1 | CodeableConcept | Empty reason Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Composition.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Composition.extension:diagnosticReport.​value[x].type | Base | extensible | ResourceType | 📍4.0.1 | FHIR Std.
Composition.status | Base | required | CompositionStatus | 📍4.0.1 | FHIR Std.
Composition.type | Base | preferred | Laboratory Report Types | 📦2.0.0 | This IG
Composition.category | Base | example | Document Class Value Set | 📍4.0.1 | FHIR Std.
Composition.category:studyType | Base | required | Laboratory Study Types | 📦2.0.0 | This IG
Composition.category:specialty | Base | required | Laboratory Specialty | 📦2.0.0 | This IG
Composition.confidentiality | Base | required | V3 Value SetConfidentialityClassification | 📍2014-03-26 | FHIR Std.
Composition.attester.​mode | Base | required | CompositionAttestationMode | 📍4.0.1 | FHIR Std.
Composition.attester:legalAuthenticator.​mode | Base | required | CompositionAttestationMode | 📍4.0.1 | FHIR Std.
Composition.attester:validator.​mode | Base | required | CompositionAttestationMode | 📍4.0.1 | FHIR Std.
Composition.relatesTo.​code | Base | required | DocumentRelationshipType | 📍4.0.1 | FHIR Std.
Composition.event.code | Base | example | v3 Code System ActCode | 📦3.0.0 | THO v7.1
Composition.section.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:annotations.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:annotations.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:annotations.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:annotations.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.
Composition.section:attachment.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section:attachment.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section:attachment.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section:attachment.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
cmp-1 | error | Composition.section, Composition.section:annotations, Composition.section:attachment | A section must contain at least one of text, entries, or sub-sections | `text.exists() or entry.exists() or section.exists()`
cmp-2 | error | Composition.section, Composition.section:annotations, Composition.section:attachment | A section can only have an emptyReason if it is empty | `emptyReason.empty() or entry.empty()`
dom-2 | error | Composition | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Composition | 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 | error | Composition | 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 | error | Composition | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Composition | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from CompositionEuCore

Summary

Mandatory: 1 element(3 nested mandatory elements)
Prohibited: 3 elements

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Composition.category
- The element 1 is sliced based on the value of Composition.section

Maturity: 2

Other representations of profile: CSV, Excel, Schematron

### Notes:

#### Section Modeling Variants

The profile allows both section modeling variants:

1. Top-level section(s) with direct `entry` elements (no sub-sections)
2. Top-level section(s) that contain nested sub-sections

Example with sub-sections:

- BundleLabResultMicroCultureSusc

Example without sub-sections:

- BundleHepatitisPanel