MyHealth@Eu Medical Imaging Report
0.0.1 - ci-build 150

MyHealth@Eu Medical Imaging Report - Local Development build (v0.0.1) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: CompositionImgMyHealthEu - Detailed Descriptions

Draft as of 2025-06-25

Definitions for the composition-img-myhealtheu resource profile.

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

0. Composition
Definition

Imaging Study Report composition.

A composition is a set of healthcare-related information that is assembled together into a single logical document that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement.

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

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


A set of healthcare-related information that is assembled together into a single logical package that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. A Composition defines the structure and narrative content necessary for a document. However, a Composition alone does not constitute a document. Rather, the Composition must be the first entry in a Bundle where Bundle.type=document, and any other resources referenced from Composition must be included as subsequent entries in the Bundle (for example Patient, Practitioner, Encounter, etc.).

ShortA set of resources composed into a single coherent clinical statement with clinical attestation
Comments

While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical.

Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. Composition.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Composition.language
Definition

The base language in which the resource is written.

ShortLanguage of the resource content
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Control10..1
BindingThe codes SHALL be taken from The codes SHOULD be taken from eHDSI Languagehttp://hl7.org/fhir/ValueSet/languages
(required to http://fhir.ehdsi.eu/imaging/ValueSet/eHDSILanguage)
Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Obligations
    ObligationsActor
    SHALL:handleImaging Handler
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    6. Composition.extension
    Definition

    An Extension


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

    ShortExtensionAdditional content defined by implementations
    Comments

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

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

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

      ShortDocument DiagnosticReport Reference
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(Document DiagnosticReport Reference) (Extension Type: Reference(DiagnosticReport))
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      10. Composition.extension:diagnosticreport-reference.extension
      Definition

      An Extension


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

      ShortExtensionAdditional content defined by implementations
      Comments

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

      Control0..0*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis 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
      • 12. Composition.extension:diagnosticreport-reference.url
        Definition

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

        Shortidentifies the meaning of the extension
        Comments

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

        Control1..1
        Typeuri
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        Fixed Valuehttp://fhir.ehdsi.eu/imaging/StructureDefinition/im-composition-diagnosticReportReference
        14. Composition.extension:diagnosticreport-reference.value[x]
        Definition

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

        ShortValue of extension
        Control0..1
        TypeReference(DiagnosticReport: Imaging), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        16. Composition.extension:basedOn
        Slice NamebasedOn
        Definition

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

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

        An Extension


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

        ShortExtensionAdditional content defined by implementations
        Comments

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

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

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

          Shortidentifies the meaning of the extension
          Comments

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

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

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


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

          ShortValue of extension
          Control10..1
          This element is affected by the following invariants: ext-1
          TypeReference(ServiceRequest: Imaging), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          24. Composition.extension:informationRecipient
          Slice NameinformationRecipient
          Definition

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

          ShortComposition: Information recipient
          Control0..*
          This element is affected by the following invariants: ele-1
          TypeExtension(Composition: Information recipient) (Extension Type: Reference(Practitioner, Device, Patient, RelatedPerson, PractitionerRole, Organization))
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          26. Composition.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

          ShortExtensions that cannot be ignored
          Comments

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

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

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

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

          A version-independent identifier for the Composition. This identifier stays constant as the composition is changed over time.

          ShortVersion-independent identifier for the Composition
          Comments

          Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate.

          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control10..1
          TypeIdentifier
          Is Modifierfalse
          Obligations
            ObligationsActor
            SHALL:handleImaging Handler
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            30. Composition.status
            Definition

            The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.

            Shortpreliminary | final | amended | entered-in-error
            Comments

            If a composition is marked as withdrawn, the compositions/documents in the series, or data from the composition or document series, should never be displayed to a user without being clearly marked as untrustworthy. The flag "entered-in-error" is why this element is labeled as a modifier of other elements.

            Some reporting work flows require that the original narrative of a final document never be altered; instead, only new narrative can be added. The composition resource has no explicit status for explicitly noting whether this business rule is in effect. This would be handled by an extension if required.

            Control1..1
            BindingThe codes SHALL be taken from CompositionStatushttp://hl7.org/fhir/ValueSet/composition-status|4.0.1
            (required to http://hl7.org/fhir/ValueSet/composition-status|4.0.1)

            The workflow/clinical status of the composition.

            Typecode
            Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Obligations
              ObligationsActor
              SHALL:handleImaging Handler
              Summarytrue
              Requirements

              Need to be able to mark interim, amended, or withdrawn compositions or documents.

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

              Specifies the particular kind of composition (e.g. History and Physical, Discharge Summary, Progress Note). This usually equates to the purpose of making the composition.

              ShortKind of composition (LOINC if possible)
              Comments

              For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation guides will require a specific LOINC code, or use LOINC as an extensible binding.

              Control1..1
              BindingThe codes SHALL be taken from The codes SHOULD be taken from eHDSI Imaging Diagnostic Report Typeshttp://hl7.org/fhir/ValueSet/doc-typecodes
              (required to http://fhir.ehdsi.eu/imaging/ValueSet/eHDSILaboratoryReportTypes)
              TypeCodeableConcept
              Is Modifierfalse
              Obligations
                ObligationsActor
                SHALL:handleImaging Handler
                Summarytrue
                Requirements

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

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

                Who or what the composition is about. The composition can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure).

                ShortWho and/or what the composition is about
                Comments

                For clinical documents, this is usually the patient.

                Control10..1
                TypeReference(Patient: Imaging Study Report, Resource)
                Is Modifierfalse
                Obligations
                  ObligationsActor
                  SHALL:handleImaging Handler
                  Summarytrue
                  Requirements

                  Essential metadata for searching for the composition. Identifies who and/or what the composition/document is about.

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

                  The composition editing time, when the composition was last logically changed by the author.

                  ShortComposition editing time
                  Comments

                  The Last Modified Date on the composition may be after the date of the document was attested without being changed.

                  Control1..1
                  TypedateTime
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Obligations
                    ObligationsActor
                    SHALL:handleImaging Handler
                    Summarytrue
                    Requirements

                    dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring. When packaged in a document, Bundle.timestamp is the date of packaging.


                    dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring. When packaged in a document, Bundle.timestamp is the date of packaging.

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

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

                    ShortWho and/or what authored the composition
                    Control1..*
                    TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                    Is Modifierfalse
                    Obligations
                      ObligationsActor
                      SHALL:handleImaging Handler
                      Summarytrue
                      Requirements

                      Identifies who is responsible for the content.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      SlicingThis element introduces a set of slices on Composition.author. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • profile @ $this
                      • 40. Composition.author:author
                        Slice Nameauthor
                        Definition

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

                        ShortWho and/or what authored the composition
                        Control01..*
                        TypeReference(PractitionerRole: Imaging, Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                        Is Modifierfalse
                        Summarytrue
                        Requirements

                        Identifies who is responsible for the content.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        42. Composition.author:authoringDevice
                        Slice NameauthoringDevice
                        Definition

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

                        ShortWho and/or what authored the composition
                        Control01..*
                        TypeReference(Device, Practitioner, PractitionerRole, Patient, RelatedPerson, Organization)
                        Is Modifierfalse
                        Summarytrue
                        Requirements

                        Identifies who is responsible for the content.

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

                        Official human-readable label for the composition.

                        ShortHuman Readable name/title
                        Comments

                        For many compositions, the title is the same as the text or a display name of Composition.type (e.g. a "consultation" or "progress note"). Note that CDA does not make title mandatory, but there are no known cases where it is useful for title to be omitted, so it is mandatory here. Feedback on this requirement is welcome during the trial use period.

                        Control1..1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Obligations
                          ObligationsActor
                          SHALL:handleImaging Handler
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          46. Composition.attester
                          Definition

                          A participant who has attested to the accuracy of the composition/document.

                          ShortAttests to accuracy of composition
                          Comments

                          Only list each attester once.

                          Control0..*
                          TypeBackboneElement
                          Is Modifierfalse
                          Summaryfalse
                          Requirements

                          Identifies responsibility for the accuracy of the composition content.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          SlicingThis element introduces a set of slices on Composition.attester. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ mode
                          • 48. Composition.attester.modifierExtension
                            Definition

                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                            ShortExtensions that cannot be ignored even if unrecognized
                            Comments

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

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

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

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

                            The type of attestation the authenticator offers.

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

                            The way in which a person authenticated a composition.

                            Typecode
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summaryfalse
                            Requirements

                            Indicates the level of authority of the attestation.

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

                            When the composition was attested by the party.

                            ShortWhen the composition was attested
                            Control0..1
                            TypedateTime
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Obligations
                              ObligationsActor
                              SHALL:handleImaging Handler
                              Summaryfalse
                              Requirements

                              Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              54. Composition.attester.party
                              Definition

                              Who attested the composition in the specified way.

                              ShortWho attested the composition
                              Control0..1
                              TypeReference(Patient, RelatedPerson, Practitioner, PractitionerRole, Organization)
                              Is Modifierfalse
                              Obligations
                                ObligationsActor
                                SHALL:handleImaging Handler
                                Summaryfalse
                                Requirements

                                Identifies who has taken on the responsibility for accuracy of the composition content.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                56. Composition.attester:legalAuthenticator
                                Slice NamelegalAuthenticator
                                Definition

                                A participant who has attested to the accuracy of the composition/document.

                                ShortAttests to accuracy of composition
                                Comments

                                Only list each attester once.

                                Control0..*
                                TypeBackboneElement
                                Is Modifierfalse
                                Summaryfalse
                                Requirements

                                Identifies responsibility for the accuracy of the composition content.

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

                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                ShortExtensions that cannot be ignored even if unrecognized
                                Comments

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

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

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

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

                                The type of attestation the authenticator offers.

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

                                The way in which a person authenticated a composition.

                                Typecode
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summaryfalse
                                Requirements

                                Indicates the level of authority of the attestation.

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

                                When the composition was attested by the party.

                                ShortWhen the composition was attested
                                Control10..1
                                TypedateTime
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summaryfalse
                                Requirements

                                Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).

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

                                Who attested the composition in the specified way.

                                ShortWho attested the composition
                                Control0..1
                                TypeReference(PractitionerRole: Imaging, Patient, RelatedPerson, Practitioner, PractitionerRole, Organization)
                                Is Modifierfalse
                                Summaryfalse
                                Requirements

                                Identifies who has taken on the responsibility for accuracy of the composition content.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                66. Composition.attester:resultValidator
                                Slice NameresultValidator
                                Definition

                                A participant who has attested to the accuracy of the composition/document.

                                ShortAttests to accuracy of composition
                                Comments

                                Only list each attester once.

                                Control0..*
                                TypeBackboneElement
                                Is Modifierfalse
                                Summaryfalse
                                Requirements

                                Identifies responsibility for the accuracy of the composition content.

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

                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                ShortExtensions that cannot be ignored even if unrecognized
                                Comments

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

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

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

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

                                The type of attestation the authenticator offers.

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

                                The way in which a person authenticated a composition.

                                Typecode
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summaryfalse
                                Requirements

                                Indicates the level of authority of the attestation.

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

                                When the composition was attested by the party.

                                ShortWhen the composition was attested
                                Control10..1
                                TypedateTime
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summaryfalse
                                Requirements

                                Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).

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

                                Who attested the composition in the specified way.

                                ShortWho attested the composition
                                Control0..1
                                TypeReference(PractitionerRole: Imaging, Patient, RelatedPerson, Practitioner, PractitionerRole, Organization)
                                Is Modifierfalse
                                Summaryfalse
                                Requirements

                                Identifies who has taken on the responsibility for accuracy of the composition content.

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

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

                                ShortOrganization that manages the Imaging ReportOrganization which maintains the composition
                                Comments

                                This is useful when documents are derived from a composition - provides guidance for how to get the latest version of the document. This is optional because this is sometimes not known by the authoring system, and can be inferred by context. However, it is important that this information be known when working with a derived document, so providing a custodian is encouraged.

                                Control0..1
                                TypeReference(Organization: Imaging, Organization)
                                Is Modifierfalse
                                Summarytrue
                                Requirements

                                Identifies where to go to find the current version, where to report issues, etc.

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

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

                                ShortThe clinical service(s) being documented
                                Comments

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

                                Control20..*
                                TypeBackboneElement
                                Is Modifierfalse
                                Summarytrue
                                Requirements

                                Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                SlicingThis element introduces a set of slices on Composition.event. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ code
                                • 80. Composition.event.modifierExtension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                  ShortExtensions that cannot be ignored even if unrecognized
                                  Comments

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

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

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

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

                                  The type of imaging modality used to perform the study.


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

                                  ShortModalityThe clinical service(s) being documented
                                  Comments

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

                                  Control10..*
                                  TypeBackboneElement
                                  Is Modifierfalse
                                  Summarytrue
                                  Requirements

                                  Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  84. Composition.event:imagingstudy.modifierExtension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                  ShortExtensions that cannot be ignored even if unrecognized
                                  Comments

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

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

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

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

                                  This list of codes represents the main clinical acts, such as a colonoscopy or an appendectomy, being documented. In some cases, the event is inherent in the typeCode, such as a "History and Physical Report" in which the procedure being documented is necessarily a "History and Physical" act.

                                  ShortCode(s) that apply to the event being documented
                                  Comments

                                  An event can further specialize the act inherent in the typeCode, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more eventCodes are included, they SHALL NOT conflict with the values inherent in the classCode, practiceSettingCode or typeCode, as such a conflict would create an ambiguous situation. This short list of codes is provided to be used as key words for certain types of queries.

                                  Control0..*
                                  BindingThe codes SHALL be taken from For example codes, see eHDSI Modalityhttp://terminology.hl7.org/ValueSet/v3-ActCode
                                  (required to http://fhir.ehdsi.eu/imaging/ValueSet/eHDSIModality)
                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  88. Composition.event:imagingstudy.detail
                                  Definition

                                  The description and/or reference of the event(s) being documented. For example, this could be used to document such a colonoscopy or an appendectomy.

                                  ShortThe event(s) being documented
                                  Control10..*
                                  TypeReference(ImagingStudy, Resource)
                                  Is Modifierfalse
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  90. Composition.event:procedure
                                  Slice Nameprocedure
                                  Definition

                                  The type of imaging study performed.


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

                                  ShortStudy TypeThe clinical service(s) being documented
                                  Comments

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

                                  Control10..*
                                  TypeBackboneElement
                                  Is Modifierfalse
                                  Summarytrue
                                  Requirements

                                  Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  92. Composition.event:procedure.modifierExtension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                  ShortExtensions that cannot be ignored even if unrecognized
                                  Comments

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

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

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

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

                                  This list of codes represents the main clinical acts, such as a colonoscopy or an appendectomy, being documented. In some cases, the event is inherent in the typeCode, such as a "History and Physical Report" in which the procedure being documented is necessarily a "History and Physical" act.

                                  ShortCode(s) that apply to the event being documented
                                  Comments

                                  An event can further specialize the act inherent in the typeCode, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more eventCodes are included, they SHALL NOT conflict with the values inherent in the classCode, practiceSettingCode or typeCode, as such a conflict would create an ambiguous situation. This short list of codes is provided to be used as key words for certain types of queries.

                                  Control0..*
                                  BindingUnless not suitable, these codes SHALL be taken from For example codes, see https://www.hl7.org/fhir/valueset-procedure-reason.htmlhttp://terminology.hl7.org/ValueSet/v3-ActCode
                                  (extensible to https://www.hl7.org/fhir/valueset-procedure-reason.html)
                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  96. Composition.event:procedure.detail
                                  Definition

                                  The description and/or reference of the event(s) being documented. For example, this could be used to document such a colonoscopy or an appendectomy.

                                  ShortThe event(s) being documented
                                  Control0..*
                                  TypeReference(Procedure, Resource)
                                  Is Modifierfalse
                                  Summarytrue
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  98. Composition.section
                                  Definition

                                  The root of the sections that make up the composition.

                                  ShortComposition is broken into sections
                                  Control20..*
                                  TypeBackboneElement
                                  Is Modifierfalse
                                  Summaryfalse
                                  Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                  cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                  ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  eu-imaging-composition-1: When a section is empty, the emptyReason extension SHALL be present. (entry.empty() and emptyReason.exists())
                                  cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                  cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                  SlicingThis element introduces a set of slices on Composition.section. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • value @ code
                                  • 100. Composition.section.modifierExtension
                                    Definition

                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                    ShortExtensions that cannot be ignored even if unrecognized
                                    Comments

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

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

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

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

                                    The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                    ShortLabel for section (e.g. for ToC)
                                    Comments

                                    The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Obligations
                                      ObligationsActor
                                      SHALL:handleImaging Handler
                                      Summaryfalse
                                      Requirements

                                      Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                      Alternate Namesheader, label, caption
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      104. Composition.section.code
                                      Definition

                                      A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                      ShortClassification of section (recommended)
                                      Comments

                                      The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                      Control10..1
                                      BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                      Classification of a section of a composition/document.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Obligations
                                        ObligationsActor
                                        SHALL:handleImaging Handler
                                        Summaryfalse
                                        Requirements

                                        Provides computable standardized labels to topics within the document.

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

                                        A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

                                        ShortText summary of the section, for human interpretation
                                        Comments

                                        Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                        Control0..1
                                        This element is affected by the following invariants: cmp-1
                                        TypeNarrative
                                        Is Modifierfalse
                                        Obligations
                                          ObligationsActor
                                          SHALL:handleImaging Handler
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          108. Composition.section.entry
                                          Definition

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

                                          ShortA reference to data that supports this section
                                          Comments

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

                                          Control0..*
                                          This element is affected by the following invariants: cmp-2
                                          TypeReference(Resource)
                                          Is Modifierfalse
                                          Obligations
                                            ObligationsActor
                                            SHALL:handleImaging Handler
                                            SHALL:handleImaging Handler
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            110. Composition.section.emptyReason
                                            Definition

                                            If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                            ShortWhy the section is empty
                                            Comments

                                            The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                            Control0..1
                                            This element is affected by the following invariants: cmp-2
                                            BindingThe codes SHOULD be taken from Reasons a section in an imaging report is empty.http://hl7.org/fhir/ValueSet/list-empty-reason
                                            (preferred to http://fhir.ehdsi.eu/imaging/ValueSet/SectionEmptyReason)
                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Summaryfalse
                                            Requirements

                                            Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            112. Composition.section:imagingstudy
                                            Slice Nameimagingstudy
                                            Definition

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


                                            The root of the sections that make up the composition.

                                            ShortImaging StudyComposition is broken into sections
                                            Control0..1*
                                            TypeBackboneElement
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                            114. Composition.section:imagingstudy.extension
                                            Definition

                                            An Extension


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

                                            ShortExtensionAdditional content defined by implementations
                                            Comments

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

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

                                              Additional notes that apply to this resource or element.

                                              ShortAdditional notes that apply to this resource or element.
                                              Comments

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

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

                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                              ShortExtensions that cannot be ignored even if unrecognized
                                              Comments

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

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

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

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

                                              A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                              ShortClassification of section (recommended)
                                              Comments

                                              The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                              If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                              Control10..1
                                              BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                              (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                              Classification of a section of a composition/document.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

                                              Provides computable standardized labels to topics within the document.

                                              Pattern Value{
                                                "coding" : [{
                                                  "system" : "http://loinc.org",
                                                  "code" : "18726-0"
                                                }]
                                              }
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              122. Composition.section:imagingstudy.entry
                                              Definition

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

                                              ShortA reference to data that supports this section
                                              Comments

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

                                              Control10..*
                                              This element is affected by the following invariants: cmp-2
                                              TypeReference(Resource)
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • profile @ $this
                                              • 124. Composition.section:imagingstudy.entry:imagingstudy
                                                Slice Nameimagingstudy
                                                Definition

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


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

                                                ShortImaging Study ReferenceA reference to data that supports this section
                                                Comments

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

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

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


                                                The root of the sections that make up the composition.

                                                ShortOrderComposition is broken into sections
                                                Control0..1*
                                                TypeBackboneElement
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                128. Composition.section:order.extension
                                                Definition

                                                An Extension


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

                                                ShortExtensionAdditional content defined by implementations
                                                Comments

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

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

                                                  Additional notes that apply to this resource or element.

                                                  ShortAdditional notes that apply to this resource or element.
                                                  Comments

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

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

                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                  Comments

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

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

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

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

                                                  A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                  ShortClassification of section (recommended)
                                                  Comments

                                                  The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                  If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                  Control10..1
                                                  BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                                  (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                  Classification of a section of a composition/document.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Provides computable standardized labels to topics within the document.

                                                  Pattern Value{
                                                    "coding" : [{
                                                      "system" : "http://loinc.org",
                                                      "code" : "55115-0",
                                                      "display" : "Requested imaging studies information Document"
                                                    }]
                                                  }
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  136. Composition.section:order.entry
                                                  Definition

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

                                                  ShortA reference to data that supports this section
                                                  Comments

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

                                                  Control0..*
                                                  This element is affected by the following invariants: cmp-2
                                                  TypeReference(Resource)
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • profile @ $this
                                                  • 138. Composition.section:order.entry:order
                                                    Slice Nameorder
                                                    Definition

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


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

                                                    ShortOrder referenceA reference to data that supports this section
                                                    Comments

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

                                                    Control0..*
                                                    This element is affected by the following invariants: cmp-2
                                                    TypeReference(ServiceRequest: Imaging, Resource)
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    140. Composition.section:history
                                                    Slice Namehistory
                                                    Definition

                                                    The root of the sections that make up the composition.

                                                    ShortHistoryComposition is broken into sections
                                                    Control0..1*
                                                    TypeBackboneElement
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                    142. Composition.section:history.extension
                                                    Definition

                                                    An Extension


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

                                                    ShortExtensionAdditional content defined by implementations
                                                    Comments

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

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

                                                      Additional notes that apply to this resource or element.

                                                      ShortAdditional notes that apply to this resource or element.
                                                      Comments

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

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

                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                      Comments

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

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

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

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

                                                      A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                      ShortClassification of section (recommended)
                                                      Comments

                                                      The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                      Control10..1
                                                      BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                                      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                      Classification of a section of a composition/document.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Provides computable standardized labels to topics within the document.

                                                      Pattern Value{
                                                        "coding" : [{
                                                          "system" : "http://loinc.org",
                                                          "code" : "11329-0",
                                                          "display" : "History general Narrative - Reported"
                                                        }]
                                                      }
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      150. Composition.section:procedure
                                                      Slice Nameprocedure
                                                      Definition

                                                      The root of the sections that make up the composition.

                                                      ShortProcedureComposition is broken into sections
                                                      Control0..1*
                                                      TypeBackboneElement
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                      152. Composition.section:procedure.extension
                                                      Definition

                                                      An Extension


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

                                                      ShortExtensionAdditional content defined by implementations
                                                      Comments

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

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

                                                        Additional notes that apply to this resource or element.

                                                        ShortAdditional notes that apply to this resource or element.
                                                        Comments

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

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

                                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                        Comments

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

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

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

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

                                                        A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                        ShortClassification of section (recommended)
                                                        Comments

                                                        The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                        If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                        Control10..1
                                                        BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                                        (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                        Classification of a section of a composition/document.

                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Provides computable standardized labels to topics within the document.

                                                        Pattern Value{
                                                          "coding" : [{
                                                            "system" : "http://loinc.org",
                                                            "code" : "55111-9",
                                                            "display" : "Current imaging procedure descriptions Document"
                                                          }]
                                                        }
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        160. Composition.section:procedure.entry
                                                        Definition

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

                                                        ShortA reference to data that supports this section
                                                        Comments

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

                                                        Control0..*
                                                        This element is affected by the following invariants: cmp-2
                                                        TypeReference(Resource)
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                        • profile @ $this
                                                        • 162. Composition.section:procedure.entry:procedure
                                                          Slice Nameprocedure
                                                          Definition

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

                                                          ShortA reference to data that supports this section
                                                          Comments

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

                                                          Control0..*
                                                          This element is affected by the following invariants: cmp-2
                                                          TypeReference(Procedure, Resource)
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          164. Composition.section:comparison
                                                          Slice Namecomparison
                                                          Definition

                                                          The root of the sections that make up the composition.

                                                          ShortHistoryComposition is broken into sections
                                                          Control0..1*
                                                          TypeBackboneElement
                                                          Is Modifierfalse
                                                          Summaryfalse
                                                          Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                          166. Composition.section:comparison.extension
                                                          Definition

                                                          An Extension


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

                                                          ShortExtensionAdditional content defined by implementations
                                                          Comments

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

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

                                                            Additional notes that apply to this resource or element.

                                                            ShortAdditional notes that apply to this resource or element.
                                                            Comments

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

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

                                                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                            Comments

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

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

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

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

                                                            A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                            ShortClassification of section (recommended)
                                                            Comments

                                                            The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                            If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                            Control10..1
                                                            BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                                            (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                            Classification of a section of a composition/document.

                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Requirements

                                                            Provides computable standardized labels to topics within the document.

                                                            Pattern Value{
                                                              "coding" : [{
                                                                "system" : "http://loinc.org",
                                                                "code" : "18834-2",
                                                                "display" : "Radiology Comparison study (narrative)"
                                                              }]
                                                            }
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            174. Composition.section:comparison.entry
                                                            Definition

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

                                                            ShortA reference to data that supports this section
                                                            Comments

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

                                                            Control0..*
                                                            This element is affected by the following invariants: cmp-2
                                                            TypeReference(Resource)
                                                            Is Modifierfalse
                                                            Summaryfalse
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                            • profile @ $this
                                                            • 176. Composition.section:comparison.entry:comparedstudy
                                                              Slice Namecomparedstudy
                                                              Definition

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

                                                              ShortA reference to data that supports this section
                                                              Comments

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

                                                              Control0..*
                                                              This element is affected by the following invariants: cmp-2
                                                              TypeReference(ImagingStudy, Resource)
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              178. Composition.section:findings
                                                              Slice Namefindings
                                                              Definition

                                                              The root of the sections that make up the composition.

                                                              ShortFindingsComposition is broken into sections
                                                              Control10..1*
                                                              TypeBackboneElement
                                                              Is Modifierfalse
                                                              Summaryfalse
                                                              Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                              180. Composition.section:findings.extension
                                                              Definition

                                                              An Extension


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

                                                              ShortExtensionAdditional content defined by implementations
                                                              Comments

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

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

                                                                Additional notes that apply to this resource or element.

                                                                ShortAdditional notes that apply to this resource or element.
                                                                Comments

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

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

                                                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                Comments

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

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

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

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

                                                                A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                ShortClassification of section (recommended)
                                                                Comments

                                                                The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                Control10..1
                                                                BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                                                (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                Classification of a section of a composition/document.

                                                                TypeCodeableConcept
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Requirements

                                                                Provides computable standardized labels to topics within the document.

                                                                Pattern Value{
                                                                  "coding" : [{
                                                                    "system" : "http://loinc.org",
                                                                    "code" : "59776-5",
                                                                    "display" : "Findings"
                                                                  }]
                                                                }
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                188. Composition.section:findings.entry
                                                                Definition

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

                                                                ShortA reference to data that supports this section
                                                                Comments

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

                                                                Control0..*
                                                                This element is affected by the following invariants: cmp-2
                                                                TypeReference(Resource)
                                                                Is Modifierfalse
                                                                Summaryfalse
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                • profile @ $this
                                                                • 190. Composition.section:findings.entry:finding
                                                                  Slice Namefinding
                                                                  Definition

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

                                                                  ShortA reference to data that supports this section
                                                                  Comments

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

                                                                  Control0..*
                                                                  This element is affected by the following invariants: cmp-2
                                                                  TypeReference(Observation Results: IDR, Resource)
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  192. Composition.section:findings.entry:keyimage
                                                                  Slice Namekeyimage
                                                                  Definition

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

                                                                  ShortA reference to data that supports this section
                                                                  Comments

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

                                                                  Control0..*
                                                                  This element is affected by the following invariants: cmp-2
                                                                  TypeReference(Imaging Key Image Document Reference, Resource)
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  194. Composition.section:impression
                                                                  Slice Nameimpression
                                                                  Definition

                                                                  The root of the sections that make up the composition.

                                                                  ShortImpressionsComposition is broken into sections
                                                                  Control0..1*
                                                                  TypeBackboneElement
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                  cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                  ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                  cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                  196. Composition.section:impression.extension
                                                                  Definition

                                                                  An Extension


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

                                                                  ShortExtensionAdditional content defined by implementations
                                                                  Comments

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

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

                                                                    Additional notes that apply to this resource or element.

                                                                    ShortAdditional notes that apply to this resource or element.
                                                                    Comments

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

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

                                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                    Comments

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

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

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

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

                                                                    A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                    ShortClassification of section (recommended)
                                                                    Comments

                                                                    The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                    If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                    Control10..1
                                                                    BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                                                    (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                    Classification of a section of a composition/document.

                                                                    TypeCodeableConcept
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Provides computable standardized labels to topics within the document.

                                                                    Pattern Value{
                                                                      "coding" : [{
                                                                        "system" : "http://loinc.org",
                                                                        "code" : "19005-8",
                                                                        "display" : "Radiology Imaging study [Impression] (narrative)"
                                                                      }]
                                                                    }
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    204. Composition.section:impression.entry
                                                                    Definition

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

                                                                    ShortA reference to data that supports this section
                                                                    Comments

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

                                                                    Control0..*
                                                                    This element is affected by the following invariants: cmp-2
                                                                    TypeReference(Resource)
                                                                    Is Modifierfalse
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                    • profile @ $this
                                                                    • 206. Composition.section:impression.entry:finding
                                                                      Slice Namefinding
                                                                      Definition

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

                                                                      ShortA reference to data that supports this section
                                                                      Comments

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

                                                                      Control0..*
                                                                      This element is affected by the following invariants: cmp-2
                                                                      TypeReference(Observation Results: IDR, Resource)
                                                                      Is Modifierfalse
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      208. Composition.section:impression.entry:impression
                                                                      Slice Nameimpression
                                                                      Definition

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

                                                                      ShortA reference to data that supports this section
                                                                      Comments

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

                                                                      Control0..*
                                                                      This element is affected by the following invariants: cmp-2
                                                                      TypeReference(Condition, Resource)
                                                                      Is Modifierfalse
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      210. Composition.section:impression.entry:keyimage
                                                                      Slice Namekeyimage
                                                                      Definition

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

                                                                      ShortA reference to data that supports this section
                                                                      Comments

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

                                                                      Control0..*
                                                                      This element is affected by the following invariants: cmp-2
                                                                      TypeReference(Imaging Key Image Document Reference, Resource)
                                                                      Is Modifierfalse
                                                                      Summaryfalse
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      212. Composition.section:recommendation
                                                                      Slice Namerecommendation
                                                                      Definition

                                                                      The root of the sections that make up the composition.

                                                                      ShortRecommendationsComposition is broken into sections
                                                                      Control10..1*
                                                                      TypeBackboneElement
                                                                      Is Modifierfalse
                                                                      Summaryfalse
                                                                      Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                      214. Composition.section:recommendation.extension
                                                                      Definition

                                                                      An Extension


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

                                                                      ShortExtensionAdditional content defined by implementations
                                                                      Comments

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

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

                                                                        Additional notes that apply to this resource or element.

                                                                        ShortAdditional notes that apply to this resource or element.
                                                                        Comments

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

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

                                                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                                        Comments

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

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

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

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

                                                                        A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                        ShortClassification of section (recommended)
                                                                        Comments

                                                                        The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                        If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                        Control10..1
                                                                        BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                                                        (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                        Classification of a section of a composition/document.

                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Provides computable standardized labels to topics within the document.

                                                                        Pattern Value{
                                                                          "coding" : [{
                                                                            "system" : "http://loinc.org",
                                                                            "code" : "18783-1",
                                                                            "display" : "Radiology Study recommendation (narrative)"
                                                                          }]
                                                                        }
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        222. Composition.section:recommendation.entry
                                                                        Definition

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

                                                                        ShortA reference to data that supports this section
                                                                        Comments

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

                                                                        Control0..*
                                                                        This element is affected by the following invariants: cmp-2
                                                                        TypeReference(Resource)
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                        • profile @ $this
                                                                        • 224. Composition.section:recommendation.entry:careplan
                                                                          Slice Namecareplan
                                                                          Definition

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

                                                                          ShortA reference to data that supports this section
                                                                          Comments

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

                                                                          Control0..*
                                                                          This element is affected by the following invariants: cmp-2
                                                                          TypeReference(CarePlan, Resource)
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          226. Composition.section:communication
                                                                          Slice Namecommunication
                                                                          Definition

                                                                          The root of the sections that make up the composition.

                                                                          ShortCommunicationsComposition is broken into sections
                                                                          Control0..1*
                                                                          TypeBackboneElement
                                                                          Is Modifierfalse
                                                                          Summaryfalse
                                                                          Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                          228. Composition.section:communication.extension
                                                                          Definition

                                                                          An Extension


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

                                                                          ShortExtensionAdditional content defined by implementations
                                                                          Comments

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

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

                                                                            Additional notes that apply to this resource or element.

                                                                            ShortAdditional notes that apply to this resource or element.
                                                                            Comments

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

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

                                                                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                                            Comments

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

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

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

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

                                                                            A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                            ShortClassification of section (recommended)
                                                                            Comments

                                                                            The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                            If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                            Control10..1
                                                                            BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                                                            (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                            Classification of a section of a composition/document.

                                                                            TypeCodeableConcept
                                                                            Is Modifierfalse
                                                                            Summaryfalse
                                                                            Requirements

                                                                            Provides computable standardized labels to topics within the document.

                                                                            Pattern Value{
                                                                              "coding" : [{
                                                                                "system" : "http://loinc.org",
                                                                                "code" : "18783-1",
                                                                                "display" : "Radiology Study recommendation (narrative)"
                                                                              }]
                                                                            }
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

                                                                            0. Composition
                                                                            Definition

                                                                            Imaging Study Report composition.

                                                                            A composition is a set of healthcare-related information that is assembled together into a single logical document that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement.

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

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

                                                                            2. Composition.language
                                                                            Control1..?
                                                                            BindingThe codes SHALL be taken from eHDSI Language
                                                                            (required to http://fhir.ehdsi.eu/imaging/ValueSet/eHDSILanguage)
                                                                            Obligations
                                                                              ObligationsActor
                                                                              SHALL:handleImaging Handler
                                                                              4. Composition.extension
                                                                              SlicingThis element introduces a set of slices on Composition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                              • value @ url
                                                                              • 6. Composition.extension:diagnosticreport-reference
                                                                                Slice Namediagnosticreport-reference
                                                                                Control0..1
                                                                                TypeExtension(Document DiagnosticReport Reference) (Extension Type: Reference(DiagnosticReport))
                                                                                8. Composition.extension:diagnosticreport-reference.value[x]
                                                                                TypeReference(DiagnosticReport: Imaging)
                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                10. Composition.extension:basedOn
                                                                                Slice NamebasedOn
                                                                                Control0..*
                                                                                TypeExtension(Based on) (Extension Type: Reference(Resource))
                                                                                12. Composition.extension:basedOn.value[x]
                                                                                TypeReference(ServiceRequest: Imaging)
                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                14. Composition.extension:informationRecipient
                                                                                Slice NameinformationRecipient
                                                                                Control0..*
                                                                                TypeExtension(Composition: Information recipient) (Extension Type: Reference(Practitioner, Device, Patient, RelatedPerson, PractitionerRole, Organization))
                                                                                16. Composition.identifier
                                                                                NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                                Control1..?
                                                                                Obligations
                                                                                  ObligationsActor
                                                                                  SHALL:handleImaging Handler
                                                                                  18. Composition.status
                                                                                  Obligations
                                                                                    ObligationsActor
                                                                                    SHALL:handleImaging Handler
                                                                                    20. Composition.type
                                                                                    BindingThe codes SHALL be taken from eHDSI Imaging Diagnostic Report Types
                                                                                    (required to http://fhir.ehdsi.eu/imaging/ValueSet/eHDSILaboratoryReportTypes)
                                                                                    Obligations
                                                                                      ObligationsActor
                                                                                      SHALL:handleImaging Handler
                                                                                      22. Composition.subject
                                                                                      Control1..?
                                                                                      TypeReference(Patient: Imaging Study Report)
                                                                                      Obligations
                                                                                        ObligationsActor
                                                                                        SHALL:handleImaging Handler
                                                                                        24. Composition.date
                                                                                        Obligations
                                                                                          ObligationsActor
                                                                                          SHALL:handleImaging Handler
                                                                                          26. Composition.author
                                                                                          Obligations
                                                                                            ObligationsActor
                                                                                            SHALL:handleImaging Handler
                                                                                            SlicingThis element introduces a set of slices on Composition.author. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                            • profile @ $this
                                                                                            • 28. Composition.author:author
                                                                                              Slice Nameauthor
                                                                                              Control0..*
                                                                                              TypeReference(PractitionerRole: Imaging)
                                                                                              30. Composition.author:authoringDevice
                                                                                              Slice NameauthoringDevice
                                                                                              Control0..*
                                                                                              TypeReference(Device)
                                                                                              32. Composition.title
                                                                                              Obligations
                                                                                                ObligationsActor
                                                                                                SHALL:handleImaging Handler
                                                                                                34. Composition.attester
                                                                                                SlicingThis element introduces a set of slices on Composition.attester. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                • value @ mode
                                                                                                • 36. Composition.attester.time
                                                                                                  Obligations
                                                                                                    ObligationsActor
                                                                                                    SHALL:handleImaging Handler
                                                                                                    38. Composition.attester.party
                                                                                                    Obligations
                                                                                                      ObligationsActor
                                                                                                      SHALL:handleImaging Handler
                                                                                                      40. Composition.attester:legalAuthenticator
                                                                                                      Slice NamelegalAuthenticator
                                                                                                      Control0..*
                                                                                                      42. Composition.attester:legalAuthenticator.mode
                                                                                                      Pattern Valuelegal
                                                                                                      44. Composition.attester:legalAuthenticator.time
                                                                                                      Control1..?
                                                                                                      46. Composition.attester:legalAuthenticator.party
                                                                                                      TypeReference(PractitionerRole: Imaging)
                                                                                                      48. Composition.attester:resultValidator
                                                                                                      Slice NameresultValidator
                                                                                                      Control0..*
                                                                                                      50. Composition.attester:resultValidator.mode
                                                                                                      Pattern Valueprofessional
                                                                                                      52. Composition.attester:resultValidator.time
                                                                                                      Control1..?
                                                                                                      54. Composition.attester:resultValidator.party
                                                                                                      TypeReference(PractitionerRole: Imaging)
                                                                                                      56. Composition.custodian
                                                                                                      ShortOrganization that manages the Imaging Report
                                                                                                      TypeReference(Organization: Imaging)
                                                                                                      58. Composition.event
                                                                                                      Control2..?
                                                                                                      SlicingThis element introduces a set of slices on Composition.event. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                      • value @ code
                                                                                                      • 60. Composition.event:imagingstudy
                                                                                                        Slice Nameimagingstudy
                                                                                                        Definition

                                                                                                        The type of imaging modality used to perform the study.

                                                                                                        ShortModality
                                                                                                        Control1..*
                                                                                                        62. Composition.event:imagingstudy.code
                                                                                                        BindingThe codes SHALL be taken from eHDSI Modality
                                                                                                        (required to http://fhir.ehdsi.eu/imaging/ValueSet/eHDSIModality)
                                                                                                        64. Composition.event:imagingstudy.detail
                                                                                                        Control1..?
                                                                                                        TypeReference(ImagingStudy)
                                                                                                        66. Composition.event:procedure
                                                                                                        Slice Nameprocedure
                                                                                                        Definition

                                                                                                        The type of imaging study performed.

                                                                                                        ShortStudy Type
                                                                                                        Control1..*
                                                                                                        68. Composition.event:procedure.code
                                                                                                        BindingUnless not suitable, these codes SHALL be taken from https://www.hl7.org/fhir/valueset-procedure-reason.html
                                                                                                        (extensible to https://www.hl7.org/fhir/valueset-procedure-reason.html)
                                                                                                        70. Composition.event:procedure.detail
                                                                                                        TypeReference(Procedure)
                                                                                                        72. Composition.section
                                                                                                        Control2..?
                                                                                                        Invariantseu-imaging-composition-1: When a section is empty, the emptyReason extension SHALL be present. (entry.empty() and emptyReason.exists())
                                                                                                        SlicingThis element introduces a set of slices on Composition.section. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                        • value @ code
                                                                                                        • 74. Composition.section.title
                                                                                                          Obligations
                                                                                                            ObligationsActor
                                                                                                            SHALL:handleImaging Handler
                                                                                                            76. Composition.section.code
                                                                                                            Control1..?
                                                                                                            Obligations
                                                                                                              ObligationsActor
                                                                                                              SHALL:handleImaging Handler
                                                                                                              78. Composition.section.text
                                                                                                              Obligations
                                                                                                                ObligationsActor
                                                                                                                SHALL:handleImaging Handler
                                                                                                                80. Composition.section.entry
                                                                                                                Obligations
                                                                                                                  ObligationsActor
                                                                                                                  SHALL:handleImaging Handler
                                                                                                                  SHALL:handleImaging Handler
                                                                                                                  82. Composition.section.emptyReason
                                                                                                                  BindingThe codes SHOULD be taken from Reasons a section in an imaging report is empty.
                                                                                                                  (preferred to http://fhir.ehdsi.eu/imaging/ValueSet/SectionEmptyReason)
                                                                                                                  84. Composition.section:imagingstudy
                                                                                                                  Slice Nameimagingstudy
                                                                                                                  Definition

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

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

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

                                                                                                                      ShortImaging Study Reference
                                                                                                                      Control1..*
                                                                                                                      TypeReference(Medical Imaging Report Imaging Study)
                                                                                                                      96. Composition.section:order
                                                                                                                      Slice Nameorder
                                                                                                                      Definition

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

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

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

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

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

                                                                                                                                                  0. Composition
                                                                                                                                                  Definition

                                                                                                                                                  Imaging Study Report composition.

                                                                                                                                                  A composition is a set of healthcare-related information that is assembled together into a single logical document that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement.

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

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

                                                                                                                                                  ShortA set of resources composed into a single coherent clinical statement with clinical attestation
                                                                                                                                                  Comments

                                                                                                                                                  While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical.

                                                                                                                                                  Control0..*
                                                                                                                                                  Is Modifierfalse
                                                                                                                                                  Summaryfalse
                                                                                                                                                  Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                                                                                                                                                  dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
                                                                                                                                                  dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                                                                                                                                                  dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                                                                                                                                                  dom-6: A resource should have narrative for robust management (text.`div`.exists())
                                                                                                                                                  2. Composition.id
                                                                                                                                                  Definition

                                                                                                                                                  The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

                                                                                                                                                  ShortLogical id of this artifact
                                                                                                                                                  Comments

                                                                                                                                                  The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

                                                                                                                                                  Control0..1
                                                                                                                                                  Typeid
                                                                                                                                                  Is Modifierfalse
                                                                                                                                                  Summarytrue
                                                                                                                                                  4. Composition.meta
                                                                                                                                                  Definition

                                                                                                                                                  The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

                                                                                                                                                  ShortMetadata about the resource
                                                                                                                                                  Control0..1
                                                                                                                                                  TypeMeta
                                                                                                                                                  Is Modifierfalse
                                                                                                                                                  Summarytrue
                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                  6. Composition.implicitRules
                                                                                                                                                  Definition

                                                                                                                                                  A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                                                                                                                                                  ShortA set of rules under which this content was created
                                                                                                                                                  Comments

                                                                                                                                                  Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                                                                                                                                                  Control0..1
                                                                                                                                                  Typeuri
                                                                                                                                                  Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                                                                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                  Summarytrue
                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                  8. Composition.language
                                                                                                                                                  Definition

                                                                                                                                                  The base language in which the resource is written.

                                                                                                                                                  ShortLanguage of the resource content
                                                                                                                                                  Comments

                                                                                                                                                  Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

                                                                                                                                                  Control1..1
                                                                                                                                                  BindingThe codes SHALL be taken from eHDSI Language
                                                                                                                                                  (required to http://fhir.ehdsi.eu/imaging/ValueSet/eHDSILanguage)
                                                                                                                                                  Typecode
                                                                                                                                                  Is Modifierfalse
                                                                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                  Obligations
                                                                                                                                                    ObligationsActor
                                                                                                                                                    SHALL:handleImaging Handler
                                                                                                                                                    Summaryfalse
                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    10. Composition.text
                                                                                                                                                    Definition

                                                                                                                                                    A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                                                                    ShortText summary of the resource, for human interpretation
                                                                                                                                                    Comments

                                                                                                                                                    Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

                                                                                                                                                    Control0..1
                                                                                                                                                    TypeNarrative
                                                                                                                                                    Is Modifierfalse
                                                                                                                                                    Summaryfalse
                                                                                                                                                    Alternate Namesnarrative, html, xhtml, display
                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    12. Composition.contained
                                                                                                                                                    Definition

                                                                                                                                                    These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

                                                                                                                                                    ShortContained, inline Resources
                                                                                                                                                    Comments

                                                                                                                                                    This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

                                                                                                                                                    Control0..*
                                                                                                                                                    TypeResource
                                                                                                                                                    Is Modifierfalse
                                                                                                                                                    Summaryfalse
                                                                                                                                                    Alternate Namesinline resources, anonymous resources, contained resources
                                                                                                                                                    14. Composition.extension
                                                                                                                                                    Definition

                                                                                                                                                    An Extension

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

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

                                                                                                                                                      ShortDocument DiagnosticReport Reference
                                                                                                                                                      Control0..1
                                                                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                                                                      TypeExtension(Document DiagnosticReport Reference) (Extension Type: Reference(DiagnosticReport))
                                                                                                                                                      Is Modifierfalse
                                                                                                                                                      Summaryfalse
                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                      18. Composition.extension:diagnosticreport-reference.id
                                                                                                                                                      Definition

                                                                                                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                      ShortUnique id for inter-element referencing
                                                                                                                                                      Control0..1
                                                                                                                                                      Typestring
                                                                                                                                                      Is Modifierfalse
                                                                                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                      Summaryfalse
                                                                                                                                                      20. Composition.extension:diagnosticreport-reference.extension
                                                                                                                                                      Definition

                                                                                                                                                      An Extension

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

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

                                                                                                                                                        Shortidentifies the meaning of the extension
                                                                                                                                                        Comments

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

                                                                                                                                                        Control1..1
                                                                                                                                                        Typeuri
                                                                                                                                                        Is Modifierfalse
                                                                                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                        Summaryfalse
                                                                                                                                                        Fixed Valuehttp://fhir.ehdsi.eu/imaging/StructureDefinition/im-composition-diagnosticReportReference
                                                                                                                                                        24. Composition.extension:diagnosticreport-reference.value[x]
                                                                                                                                                        Definition

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

                                                                                                                                                        ShortValue of extension
                                                                                                                                                        Control0..1
                                                                                                                                                        TypeReference(DiagnosticReport: Imaging)
                                                                                                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                        Is Modifierfalse
                                                                                                                                                        Summaryfalse
                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                        26. Composition.extension:basedOn
                                                                                                                                                        Slice NamebasedOn
                                                                                                                                                        Definition

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

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

                                                                                                                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                        ShortUnique id for inter-element referencing
                                                                                                                                                        Control0..1
                                                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                                                        Typeid
                                                                                                                                                        Is Modifierfalse
                                                                                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                        Summaryfalse
                                                                                                                                                        30. Composition.extension:basedOn.extension
                                                                                                                                                        Definition

                                                                                                                                                        An Extension

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

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

                                                                                                                                                          Shortidentifies the meaning of the extension
                                                                                                                                                          Comments

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

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

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

                                                                                                                                                          ShortValue of extension
                                                                                                                                                          Control1..1
                                                                                                                                                          This element is affected by the following invariants: ext-1
                                                                                                                                                          TypeReference(ServiceRequest: Imaging)
                                                                                                                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                          Is Modifierfalse
                                                                                                                                                          Summaryfalse
                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                          36. Composition.extension:informationRecipient
                                                                                                                                                          Slice NameinformationRecipient
                                                                                                                                                          Definition

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

                                                                                                                                                          ShortComposition: Information recipient
                                                                                                                                                          Control0..*
                                                                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                                                                          TypeExtension(Composition: Information recipient) (Extension Type: Reference(Practitioner, Device, Patient, RelatedPerson, PractitionerRole, Organization))
                                                                                                                                                          Is Modifierfalse
                                                                                                                                                          Summaryfalse
                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                          38. Composition.modifierExtension
                                                                                                                                                          Definition

                                                                                                                                                          May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                                                                                                                                          ShortExtensions that cannot be ignored
                                                                                                                                                          Comments

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

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

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

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

                                                                                                                                                          A version-independent identifier for the Composition. This identifier stays constant as the composition is changed over time.

                                                                                                                                                          ShortVersion-independent identifier for the Composition
                                                                                                                                                          Comments

                                                                                                                                                          Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate.

                                                                                                                                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                                                                                                          Control1..1
                                                                                                                                                          TypeIdentifier
                                                                                                                                                          Is Modifierfalse
                                                                                                                                                          Obligations
                                                                                                                                                            ObligationsActor
                                                                                                                                                            SHALL:handleImaging Handler
                                                                                                                                                            Summarytrue
                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                            42. Composition.status
                                                                                                                                                            Definition

                                                                                                                                                            The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.

                                                                                                                                                            Shortpreliminary | final | amended | entered-in-error
                                                                                                                                                            Comments

                                                                                                                                                            If a composition is marked as withdrawn, the compositions/documents in the series, or data from the composition or document series, should never be displayed to a user without being clearly marked as untrustworthy. The flag "entered-in-error" is why this element is labeled as a modifier of other elements.

                                                                                                                                                            Some reporting work flows require that the original narrative of a final document never be altered; instead, only new narrative can be added. The composition resource has no explicit status for explicitly noting whether this business rule is in effect. This would be handled by an extension if required.

                                                                                                                                                            Control1..1
                                                                                                                                                            BindingThe codes SHALL be taken from CompositionStatus
                                                                                                                                                            (required to http://hl7.org/fhir/ValueSet/composition-status|4.0.1)

                                                                                                                                                            The workflow/clinical status of the composition.

                                                                                                                                                            Typecode
                                                                                                                                                            Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                                                                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                            Obligations
                                                                                                                                                              ObligationsActor
                                                                                                                                                              SHALL:handleImaging Handler
                                                                                                                                                              Summarytrue
                                                                                                                                                              Requirements

                                                                                                                                                              Need to be able to mark interim, amended, or withdrawn compositions or documents.

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

                                                                                                                                                              Specifies the particular kind of composition (e.g. History and Physical, Discharge Summary, Progress Note). This usually equates to the purpose of making the composition.

                                                                                                                                                              ShortKind of composition (LOINC if possible)
                                                                                                                                                              Comments

                                                                                                                                                              For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation guides will require a specific LOINC code, or use LOINC as an extensible binding.

                                                                                                                                                              Control1..1
                                                                                                                                                              BindingThe codes SHALL be taken from eHDSI Imaging Diagnostic Report Types
                                                                                                                                                              (required to http://fhir.ehdsi.eu/imaging/ValueSet/eHDSILaboratoryReportTypes)
                                                                                                                                                              TypeCodeableConcept
                                                                                                                                                              Is Modifierfalse
                                                                                                                                                              Obligations
                                                                                                                                                                ObligationsActor
                                                                                                                                                                SHALL:handleImaging Handler
                                                                                                                                                                Summarytrue
                                                                                                                                                                Requirements

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

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

                                                                                                                                                                A categorization for the type of the composition - helps for indexing and searching. This may be implied by or derived from the code specified in the Composition Type.

                                                                                                                                                                ShortCategorization of Composition
                                                                                                                                                                Comments

                                                                                                                                                                This is a metadata field from XDS/MHD.

                                                                                                                                                                Control0..*
                                                                                                                                                                BindingFor example codes, see DocumentClassValueSet
                                                                                                                                                                (example to http://hl7.org/fhir/ValueSet/document-classcodes)

                                                                                                                                                                High-level kind of a clinical document at a macro level.

                                                                                                                                                                TypeCodeableConcept
                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                Summarytrue
                                                                                                                                                                Requirements

                                                                                                                                                                Helps humans to assess whether the composition is of interest when viewing an index of compositions or documents.

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

                                                                                                                                                                Who or what the composition is about. The composition can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure).

                                                                                                                                                                ShortWho and/or what the composition is about
                                                                                                                                                                Comments

                                                                                                                                                                For clinical documents, this is usually the patient.

                                                                                                                                                                Control1..1
                                                                                                                                                                TypeReference(Patient: Imaging Study Report)
                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                Obligations
                                                                                                                                                                  ObligationsActor
                                                                                                                                                                  SHALL:handleImaging Handler
                                                                                                                                                                  Summarytrue
                                                                                                                                                                  Requirements

                                                                                                                                                                  Essential metadata for searching for the composition. Identifies who and/or what the composition/document is about.

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

                                                                                                                                                                  Describes the clinical encounter or type of care this documentation is associated with.

                                                                                                                                                                  ShortContext of the Composition
                                                                                                                                                                  Control0..1
                                                                                                                                                                  TypeReference(Encounter)
                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                  Summarytrue
                                                                                                                                                                  Requirements

                                                                                                                                                                  Provides context for the composition and supports searching.

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

                                                                                                                                                                  The composition editing time, when the composition was last logically changed by the author.

                                                                                                                                                                  ShortComposition editing time
                                                                                                                                                                  Comments

                                                                                                                                                                  The Last Modified Date on the composition may be after the date of the document was attested without being changed.

                                                                                                                                                                  Control1..1
                                                                                                                                                                  TypedateTime
                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                  Obligations
                                                                                                                                                                    ObligationsActor
                                                                                                                                                                    SHALL:handleImaging Handler
                                                                                                                                                                    Summarytrue
                                                                                                                                                                    Requirements

                                                                                                                                                                    dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring. When packaged in a document, Bundle.timestamp is the date of packaging.

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

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

                                                                                                                                                                    ShortWho and/or what authored the composition
                                                                                                                                                                    Control1..*
                                                                                                                                                                    TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                    Obligations
                                                                                                                                                                      ObligationsActor
                                                                                                                                                                      SHALL:handleImaging Handler
                                                                                                                                                                      Summarytrue
                                                                                                                                                                      Requirements

                                                                                                                                                                      Identifies who is responsible for the content.

                                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                      SlicingThis element introduces a set of slices on Composition.author. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                      • profile @ $this
                                                                                                                                                                      • 56. Composition.author:author
                                                                                                                                                                        Slice Nameauthor
                                                                                                                                                                        Definition

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

                                                                                                                                                                        ShortWho and/or what authored the composition
                                                                                                                                                                        Control0..*
                                                                                                                                                                        TypeReference(PractitionerRole: Imaging)
                                                                                                                                                                        Is Modifierfalse
                                                                                                                                                                        Summarytrue
                                                                                                                                                                        Requirements

                                                                                                                                                                        Identifies who is responsible for the content.

                                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                        58. Composition.author:authoringDevice
                                                                                                                                                                        Slice NameauthoringDevice
                                                                                                                                                                        Definition

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

                                                                                                                                                                        ShortWho and/or what authored the composition
                                                                                                                                                                        Control0..*
                                                                                                                                                                        TypeReference(Device)
                                                                                                                                                                        Is Modifierfalse
                                                                                                                                                                        Summarytrue
                                                                                                                                                                        Requirements

                                                                                                                                                                        Identifies who is responsible for the content.

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

                                                                                                                                                                        Official human-readable label for the composition.

                                                                                                                                                                        ShortHuman Readable name/title
                                                                                                                                                                        Comments

                                                                                                                                                                        For many compositions, the title is the same as the text or a display name of Composition.type (e.g. a "consultation" or "progress note"). Note that CDA does not make title mandatory, but there are no known cases where it is useful for title to be omitted, so it is mandatory here. Feedback on this requirement is welcome during the trial use period.

                                                                                                                                                                        Control1..1
                                                                                                                                                                        Typestring
                                                                                                                                                                        Is Modifierfalse
                                                                                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                        Obligations
                                                                                                                                                                          ObligationsActor
                                                                                                                                                                          SHALL:handleImaging Handler
                                                                                                                                                                          Summarytrue
                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                          62. Composition.confidentiality
                                                                                                                                                                          Definition

                                                                                                                                                                          The code specifying the level of confidentiality of the Composition.

                                                                                                                                                                          ShortAs defined by affinity domain
                                                                                                                                                                          Comments

                                                                                                                                                                          The exact use of this element, and enforcement and issues related to highly sensitive documents are out of scope for the base specification, and delegated to implementation profiles (see security section). This element is labeled as a modifier because highly confidential documents must not be treated as if they are not.

                                                                                                                                                                          Control0..1
                                                                                                                                                                          BindingThe codes SHALL be taken from v3.ConfidentialityClassification (2014-03-26)
                                                                                                                                                                          (required to http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26)

                                                                                                                                                                          Codes specifying the level of confidentiality of the composition.

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

                                                                                                                                                                          A participant who has attested to the accuracy of the composition/document.

                                                                                                                                                                          ShortAttests to accuracy of composition
                                                                                                                                                                          Comments

                                                                                                                                                                          Only list each attester once.

                                                                                                                                                                          Control0..*
                                                                                                                                                                          TypeBackboneElement
                                                                                                                                                                          Is Modifierfalse
                                                                                                                                                                          Summaryfalse
                                                                                                                                                                          Requirements

                                                                                                                                                                          Identifies responsibility for the accuracy of the composition content.

                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                          SlicingThis element introduces a set of slices on Composition.attester. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                          • value @ mode
                                                                                                                                                                          • 66. Composition.attester.id
                                                                                                                                                                            Definition

                                                                                                                                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                                            ShortUnique id for inter-element referencing
                                                                                                                                                                            Control0..1
                                                                                                                                                                            Typestring
                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                                            Summaryfalse
                                                                                                                                                                            68. Composition.attester.extension
                                                                                                                                                                            Definition

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

                                                                                                                                                                            ShortAdditional content defined by implementations
                                                                                                                                                                            Comments

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

                                                                                                                                                                            Control0..*
                                                                                                                                                                            TypeExtension
                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                            Summaryfalse
                                                                                                                                                                            Alternate Namesextensions, user content
                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                                            70. Composition.attester.modifierExtension
                                                                                                                                                                            Definition

                                                                                                                                                                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                                                                                                                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                            Comments

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

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

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

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

                                                                                                                                                                            The type of attestation the authenticator offers.

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

                                                                                                                                                                            The way in which a person authenticated a composition.

                                                                                                                                                                            Typecode
                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                            Summaryfalse
                                                                                                                                                                            Requirements

                                                                                                                                                                            Indicates the level of authority of the attestation.

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

                                                                                                                                                                            When the composition was attested by the party.

                                                                                                                                                                            ShortWhen the composition was attested
                                                                                                                                                                            Control0..1
                                                                                                                                                                            TypedateTime
                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                            Obligations
                                                                                                                                                                              ObligationsActor
                                                                                                                                                                              SHALL:handleImaging Handler
                                                                                                                                                                              Summaryfalse
                                                                                                                                                                              Requirements

                                                                                                                                                                              Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).

                                                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                              76. Composition.attester.party
                                                                                                                                                                              Definition

                                                                                                                                                                              Who attested the composition in the specified way.

                                                                                                                                                                              ShortWho attested the composition
                                                                                                                                                                              Control0..1
                                                                                                                                                                              TypeReference(Patient, RelatedPerson, Practitioner, PractitionerRole, Organization)
                                                                                                                                                                              Is Modifierfalse
                                                                                                                                                                              Obligations
                                                                                                                                                                                ObligationsActor
                                                                                                                                                                                SHALL:handleImaging Handler
                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                Requirements

                                                                                                                                                                                Identifies who has taken on the responsibility for accuracy of the composition content.

                                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                78. Composition.attester:legalAuthenticator
                                                                                                                                                                                Slice NamelegalAuthenticator
                                                                                                                                                                                Definition

                                                                                                                                                                                A participant who has attested to the accuracy of the composition/document.

                                                                                                                                                                                ShortAttests to accuracy of composition
                                                                                                                                                                                Comments

                                                                                                                                                                                Only list each attester once.

                                                                                                                                                                                Control0..*
                                                                                                                                                                                TypeBackboneElement
                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                Requirements

                                                                                                                                                                                Identifies responsibility for the accuracy of the composition content.

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

                                                                                                                                                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                                                ShortUnique id for inter-element referencing
                                                                                                                                                                                Control0..1
                                                                                                                                                                                Typestring
                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                82. Composition.attester:legalAuthenticator.extension
                                                                                                                                                                                Definition

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

                                                                                                                                                                                ShortAdditional content defined by implementations
                                                                                                                                                                                Comments

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

                                                                                                                                                                                Control0..*
                                                                                                                                                                                TypeExtension
                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                Alternate Namesextensions, user content
                                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                                                84. Composition.attester:legalAuthenticator.modifierExtension
                                                                                                                                                                                Definition

                                                                                                                                                                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                                                                                                                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                Comments

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

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

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

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

                                                                                                                                                                                The type of attestation the authenticator offers.

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

                                                                                                                                                                                The way in which a person authenticated a composition.

                                                                                                                                                                                Typecode
                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                Requirements

                                                                                                                                                                                Indicates the level of authority of the attestation.

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

                                                                                                                                                                                When the composition was attested by the party.

                                                                                                                                                                                ShortWhen the composition was attested
                                                                                                                                                                                Control1..1
                                                                                                                                                                                TypedateTime
                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                Requirements

                                                                                                                                                                                Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).

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

                                                                                                                                                                                Who attested the composition in the specified way.

                                                                                                                                                                                ShortWho attested the composition
                                                                                                                                                                                Control0..1
                                                                                                                                                                                TypeReference(PractitionerRole: Imaging)
                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                Requirements

                                                                                                                                                                                Identifies who has taken on the responsibility for accuracy of the composition content.

                                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                92. Composition.attester:resultValidator
                                                                                                                                                                                Slice NameresultValidator
                                                                                                                                                                                Definition

                                                                                                                                                                                A participant who has attested to the accuracy of the composition/document.

                                                                                                                                                                                ShortAttests to accuracy of composition
                                                                                                                                                                                Comments

                                                                                                                                                                                Only list each attester once.

                                                                                                                                                                                Control0..*
                                                                                                                                                                                TypeBackboneElement
                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                Requirements

                                                                                                                                                                                Identifies responsibility for the accuracy of the composition content.

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

                                                                                                                                                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                                                ShortUnique id for inter-element referencing
                                                                                                                                                                                Control0..1
                                                                                                                                                                                Typestring
                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                96. Composition.attester:resultValidator.extension
                                                                                                                                                                                Definition

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

                                                                                                                                                                                ShortAdditional content defined by implementations
                                                                                                                                                                                Comments

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

                                                                                                                                                                                Control0..*
                                                                                                                                                                                TypeExtension
                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                Alternate Namesextensions, user content
                                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                                                98. Composition.attester:resultValidator.modifierExtension
                                                                                                                                                                                Definition

                                                                                                                                                                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                                                                                                                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                Comments

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

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

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

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

                                                                                                                                                                                The type of attestation the authenticator offers.

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

                                                                                                                                                                                The way in which a person authenticated a composition.

                                                                                                                                                                                Typecode
                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                Requirements

                                                                                                                                                                                Indicates the level of authority of the attestation.

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

                                                                                                                                                                                When the composition was attested by the party.

                                                                                                                                                                                ShortWhen the composition was attested
                                                                                                                                                                                Control1..1
                                                                                                                                                                                TypedateTime
                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                Requirements

                                                                                                                                                                                Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).

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

                                                                                                                                                                                Who attested the composition in the specified way.

                                                                                                                                                                                ShortWho attested the composition
                                                                                                                                                                                Control0..1
                                                                                                                                                                                TypeReference(PractitionerRole: Imaging)
                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                Requirements

                                                                                                                                                                                Identifies who has taken on the responsibility for accuracy of the composition content.

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

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

                                                                                                                                                                                ShortOrganization that manages the Imaging Report
                                                                                                                                                                                Comments

                                                                                                                                                                                This is useful when documents are derived from a composition - provides guidance for how to get the latest version of the document. This is optional because this is sometimes not known by the authoring system, and can be inferred by context. However, it is important that this information be known when working with a derived document, so providing a custodian is encouraged.

                                                                                                                                                                                Control0..1
                                                                                                                                                                                TypeReference(Organization: Imaging)
                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                Summarytrue
                                                                                                                                                                                Requirements

                                                                                                                                                                                Identifies where to go to find the current version, where to report issues, etc.

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

                                                                                                                                                                                Relationships that this composition has with other compositions or documents that already exist.

                                                                                                                                                                                ShortRelationships to other compositions/documents
                                                                                                                                                                                Comments

                                                                                                                                                                                A document is a version specific composition.

                                                                                                                                                                                Control0..*
                                                                                                                                                                                TypeBackboneElement
                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                110. Composition.relatesTo.id
                                                                                                                                                                                Definition

                                                                                                                                                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                                                ShortUnique id for inter-element referencing
                                                                                                                                                                                Control0..1
                                                                                                                                                                                Typestring
                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                112. Composition.relatesTo.extension
                                                                                                                                                                                Definition

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

                                                                                                                                                                                ShortAdditional content defined by implementations
                                                                                                                                                                                Comments

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

                                                                                                                                                                                Control0..*
                                                                                                                                                                                TypeExtension
                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                Alternate Namesextensions, user content
                                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                                                114. Composition.relatesTo.modifierExtension
                                                                                                                                                                                Definition

                                                                                                                                                                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                                                                                                                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                Comments

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

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

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

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

                                                                                                                                                                                The type of relationship that this composition has with anther composition or document.

                                                                                                                                                                                Shortreplaces | transforms | signs | appends
                                                                                                                                                                                Comments

                                                                                                                                                                                If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.

                                                                                                                                                                                Control1..1
                                                                                                                                                                                BindingThe codes SHALL be taken from DocumentRelationshipType
                                                                                                                                                                                (required to http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1)

                                                                                                                                                                                The type of relationship between documents.

                                                                                                                                                                                Typecode
                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                118. Composition.relatesTo.target[x]
                                                                                                                                                                                Definition

                                                                                                                                                                                The target composition/document of this relationship.

                                                                                                                                                                                ShortTarget of the relationship
                                                                                                                                                                                Control1..1
                                                                                                                                                                                TypeChoice of: Identifier, Reference(Composition)
                                                                                                                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                120. Composition.event
                                                                                                                                                                                Definition

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

                                                                                                                                                                                ShortThe clinical service(s) being documented
                                                                                                                                                                                Comments

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

                                                                                                                                                                                Control2..*
                                                                                                                                                                                TypeBackboneElement
                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                Summarytrue
                                                                                                                                                                                Requirements

                                                                                                                                                                                Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event.

                                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                SlicingThis element introduces a set of slices on Composition.event. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                                • value @ code
                                                                                                                                                                                • 122. Composition.event.id
                                                                                                                                                                                  Definition

                                                                                                                                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                                                  ShortUnique id for inter-element referencing
                                                                                                                                                                                  Control0..1
                                                                                                                                                                                  Typestring
                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                                                  Summaryfalse
                                                                                                                                                                                  124. Composition.event.extension
                                                                                                                                                                                  Definition

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

                                                                                                                                                                                  ShortAdditional content defined by implementations
                                                                                                                                                                                  Comments

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

                                                                                                                                                                                  Control0..*
                                                                                                                                                                                  TypeExtension
                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                  Summaryfalse
                                                                                                                                                                                  Alternate Namesextensions, user content
                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                                                  126. Composition.event.modifierExtension
                                                                                                                                                                                  Definition

                                                                                                                                                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                                                                                                                                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                  Comments

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

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

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

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

                                                                                                                                                                                  This list of codes represents the main clinical acts, such as a colonoscopy or an appendectomy, being documented. In some cases, the event is inherent in the typeCode, such as a "History and Physical Report" in which the procedure being documented is necessarily a "History and Physical" act.

                                                                                                                                                                                  ShortCode(s) that apply to the event being documented
                                                                                                                                                                                  Comments

                                                                                                                                                                                  An event can further specialize the act inherent in the typeCode, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more eventCodes are included, they SHALL NOT conflict with the values inherent in the classCode, practiceSettingCode or typeCode, as such a conflict would create an ambiguous situation. This short list of codes is provided to be used as key words for certain types of queries.

                                                                                                                                                                                  Control0..*
                                                                                                                                                                                  BindingFor example codes, see v3 Code System ActCode
                                                                                                                                                                                  (example to http://terminology.hl7.org/ValueSet/v3-ActCode)

                                                                                                                                                                                  This list of codes represents the main clinical acts being documented.

                                                                                                                                                                                  TypeCodeableConcept
                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                  Summarytrue
                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                  130. Composition.event.period
                                                                                                                                                                                  Definition

                                                                                                                                                                                  The period of time covered by the documentation. There is no assertion that the documentation is a complete representation for this period, only that it documents events during this time.

                                                                                                                                                                                  ShortThe period covered by the documentation
                                                                                                                                                                                  Control0..1
                                                                                                                                                                                  TypePeriod
                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                  Summarytrue
                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                  132. Composition.event.detail
                                                                                                                                                                                  Definition

                                                                                                                                                                                  The description and/or reference of the event(s) being documented. For example, this could be used to document such a colonoscopy or an appendectomy.

                                                                                                                                                                                  ShortThe event(s) being documented
                                                                                                                                                                                  Control0..*
                                                                                                                                                                                  TypeReference(Resource)
                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                  Summarytrue
                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                  134. Composition.event:imagingstudy
                                                                                                                                                                                  Slice Nameimagingstudy
                                                                                                                                                                                  Definition

                                                                                                                                                                                  The type of imaging modality used to perform the study.

                                                                                                                                                                                  ShortModality
                                                                                                                                                                                  Comments

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

                                                                                                                                                                                  Control1..*
                                                                                                                                                                                  TypeBackboneElement
                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                  Summarytrue
                                                                                                                                                                                  Requirements

                                                                                                                                                                                  Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event.

                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                  136. Composition.event:imagingstudy.id
                                                                                                                                                                                  Definition

                                                                                                                                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                                                  ShortUnique id for inter-element referencing
                                                                                                                                                                                  Control0..1
                                                                                                                                                                                  Typestring
                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                                                  Summaryfalse
                                                                                                                                                                                  138. Composition.event:imagingstudy.extension
                                                                                                                                                                                  Definition

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

                                                                                                                                                                                  ShortAdditional content defined by implementations
                                                                                                                                                                                  Comments

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

                                                                                                                                                                                  Control0..*
                                                                                                                                                                                  TypeExtension
                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                  Summaryfalse
                                                                                                                                                                                  Alternate Namesextensions, user content
                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                                                  140. Composition.event:imagingstudy.modifierExtension
                                                                                                                                                                                  Definition

                                                                                                                                                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                                                                                                                                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                  Comments

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

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

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

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

                                                                                                                                                                                  This list of codes represents the main clinical acts, such as a colonoscopy or an appendectomy, being documented. In some cases, the event is inherent in the typeCode, such as a "History and Physical Report" in which the procedure being documented is necessarily a "History and Physical" act.

                                                                                                                                                                                  ShortCode(s) that apply to the event being documented
                                                                                                                                                                                  Comments

                                                                                                                                                                                  An event can further specialize the act inherent in the typeCode, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more eventCodes are included, they SHALL NOT conflict with the values inherent in the classCode, practiceSettingCode or typeCode, as such a conflict would create an ambiguous situation. This short list of codes is provided to be used as key words for certain types of queries.

                                                                                                                                                                                  Control0..*
                                                                                                                                                                                  BindingThe codes SHALL be taken from eHDSI Modality
                                                                                                                                                                                  (required to http://fhir.ehdsi.eu/imaging/ValueSet/eHDSIModality)
                                                                                                                                                                                  TypeCodeableConcept
                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                  Summarytrue
                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                  144. Composition.event:imagingstudy.period
                                                                                                                                                                                  Definition

                                                                                                                                                                                  The period of time covered by the documentation. There is no assertion that the documentation is a complete representation for this period, only that it documents events during this time.

                                                                                                                                                                                  ShortThe period covered by the documentation
                                                                                                                                                                                  Control0..1
                                                                                                                                                                                  TypePeriod
                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                  Summarytrue
                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                  146. Composition.event:imagingstudy.detail
                                                                                                                                                                                  Definition

                                                                                                                                                                                  The description and/or reference of the event(s) being documented. For example, this could be used to document such a colonoscopy or an appendectomy.

                                                                                                                                                                                  ShortThe event(s) being documented
                                                                                                                                                                                  Control1..*
                                                                                                                                                                                  TypeReference(ImagingStudy)
                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                  Summarytrue
                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                  148. Composition.event:procedure
                                                                                                                                                                                  Slice Nameprocedure
                                                                                                                                                                                  Definition

                                                                                                                                                                                  The type of imaging study performed.

                                                                                                                                                                                  ShortStudy Type
                                                                                                                                                                                  Comments

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

                                                                                                                                                                                  Control1..*
                                                                                                                                                                                  TypeBackboneElement
                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                  Summarytrue
                                                                                                                                                                                  Requirements

                                                                                                                                                                                  Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event.

                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                  150. Composition.event:procedure.id
                                                                                                                                                                                  Definition

                                                                                                                                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                                                  ShortUnique id for inter-element referencing
                                                                                                                                                                                  Control0..1
                                                                                                                                                                                  Typestring
                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                                                  Summaryfalse
                                                                                                                                                                                  152. Composition.event:procedure.extension
                                                                                                                                                                                  Definition

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

                                                                                                                                                                                  ShortAdditional content defined by implementations
                                                                                                                                                                                  Comments

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

                                                                                                                                                                                  Control0..*
                                                                                                                                                                                  TypeExtension
                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                  Summaryfalse
                                                                                                                                                                                  Alternate Namesextensions, user content
                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                                                  154. Composition.event:procedure.modifierExtension
                                                                                                                                                                                  Definition

                                                                                                                                                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                                                                                                                                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                  Comments

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

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

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

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

                                                                                                                                                                                  This list of codes represents the main clinical acts, such as a colonoscopy or an appendectomy, being documented. In some cases, the event is inherent in the typeCode, such as a "History and Physical Report" in which the procedure being documented is necessarily a "History and Physical" act.

                                                                                                                                                                                  ShortCode(s) that apply to the event being documented
                                                                                                                                                                                  Comments

                                                                                                                                                                                  An event can further specialize the act inherent in the typeCode, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more eventCodes are included, they SHALL NOT conflict with the values inherent in the classCode, practiceSettingCode or typeCode, as such a conflict would create an ambiguous situation. This short list of codes is provided to be used as key words for certain types of queries.

                                                                                                                                                                                  Control0..*
                                                                                                                                                                                  BindingUnless not suitable, these codes SHALL be taken from https://www.hl7.org/fhir/valueset-procedure-reason.html
                                                                                                                                                                                  (extensible to https://www.hl7.org/fhir/valueset-procedure-reason.html)
                                                                                                                                                                                  TypeCodeableConcept
                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                  Summarytrue
                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                  158. Composition.event:procedure.period
                                                                                                                                                                                  Definition

                                                                                                                                                                                  The period of time covered by the documentation. There is no assertion that the documentation is a complete representation for this period, only that it documents events during this time.

                                                                                                                                                                                  ShortThe period covered by the documentation
                                                                                                                                                                                  Control0..1
                                                                                                                                                                                  TypePeriod
                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                  Summarytrue
                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                  160. Composition.event:procedure.detail
                                                                                                                                                                                  Definition

                                                                                                                                                                                  The description and/or reference of the event(s) being documented. For example, this could be used to document such a colonoscopy or an appendectomy.

                                                                                                                                                                                  ShortThe event(s) being documented
                                                                                                                                                                                  Control0..*
                                                                                                                                                                                  TypeReference(Procedure)
                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                  Summarytrue
                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                  162. Composition.section
                                                                                                                                                                                  Definition

                                                                                                                                                                                  The root of the sections that make up the composition.

                                                                                                                                                                                  ShortComposition is broken into sections
                                                                                                                                                                                  Control2..*
                                                                                                                                                                                  TypeBackboneElement
                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                  Summaryfalse
                                                                                                                                                                                  Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                                                                                                  cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                                                                                                  ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                  eu-imaging-composition-1: When a section is empty, the emptyReason extension SHALL be present. (entry.empty() and emptyReason.exists())
                                                                                                                                                                                  SlicingThis element introduces a set of slices on Composition.section. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                                  • value @ code
                                                                                                                                                                                  • 164. Composition.section.id
                                                                                                                                                                                    Definition

                                                                                                                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                                                    ShortUnique id for inter-element referencing
                                                                                                                                                                                    Control0..1
                                                                                                                                                                                    Typestring
                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                                                    Summaryfalse
                                                                                                                                                                                    166. Composition.section.extension
                                                                                                                                                                                    Definition

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

                                                                                                                                                                                    ShortAdditional content defined by implementations
                                                                                                                                                                                    Comments

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

                                                                                                                                                                                    Control0..*
                                                                                                                                                                                    TypeExtension
                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                    Summaryfalse
                                                                                                                                                                                    Alternate Namesextensions, user content
                                                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                                                    168. Composition.section.modifierExtension
                                                                                                                                                                                    Definition

                                                                                                                                                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                                                                                                                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                    Comments

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

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

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

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

                                                                                                                                                                                    The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                                                                                                    ShortLabel for section (e.g. for ToC)
                                                                                                                                                                                    Comments

                                                                                                                                                                                    The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                                                                                                    Control0..1
                                                                                                                                                                                    Typestring
                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                                    Obligations
                                                                                                                                                                                      ObligationsActor
                                                                                                                                                                                      SHALL:handleImaging Handler
                                                                                                                                                                                      Summaryfalse
                                                                                                                                                                                      Requirements

                                                                                                                                                                                      Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                                                                                                      Alternate Namesheader, label, caption
                                                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                      172. Composition.section.code
                                                                                                                                                                                      Definition

                                                                                                                                                                                      A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                                                                                                      ShortClassification of section (recommended)
                                                                                                                                                                                      Comments

                                                                                                                                                                                      The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                                                                                                      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                                                                                                      Control1..1
                                                                                                                                                                                      BindingFor example codes, see DocumentSectionCodes
                                                                                                                                                                                      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                                                                                                                      Classification of a section of a composition/document.

                                                                                                                                                                                      TypeCodeableConcept
                                                                                                                                                                                      Is Modifierfalse
                                                                                                                                                                                      Obligations
                                                                                                                                                                                        ObligationsActor
                                                                                                                                                                                        SHALL:handleImaging Handler
                                                                                                                                                                                        Summaryfalse
                                                                                                                                                                                        Requirements

                                                                                                                                                                                        Provides computable standardized labels to topics within the document.

                                                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                        174. Composition.section.author
                                                                                                                                                                                        Definition

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

                                                                                                                                                                                        ShortWho and/or what authored the section
                                                                                                                                                                                        Control0..*
                                                                                                                                                                                        TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                                                                                                        Is Modifierfalse
                                                                                                                                                                                        Summaryfalse
                                                                                                                                                                                        Requirements

                                                                                                                                                                                        Identifies who is responsible for the content.

                                                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                        176. Composition.section.focus
                                                                                                                                                                                        Definition

                                                                                                                                                                                        The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                                                                                                        ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                                                                                                        Comments

                                                                                                                                                                                        Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                                                                                                                        Control0..1
                                                                                                                                                                                        TypeReference(Resource)
                                                                                                                                                                                        Is Modifierfalse
                                                                                                                                                                                        Summaryfalse
                                                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                        178. Composition.section.text
                                                                                                                                                                                        Definition

                                                                                                                                                                                        A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

                                                                                                                                                                                        ShortText summary of the section, for human interpretation
                                                                                                                                                                                        Comments

                                                                                                                                                                                        Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                                                                                                        Control0..1
                                                                                                                                                                                        This element is affected by the following invariants: cmp-1
                                                                                                                                                                                        TypeNarrative
                                                                                                                                                                                        Is Modifierfalse
                                                                                                                                                                                        Obligations
                                                                                                                                                                                          ObligationsActor
                                                                                                                                                                                          SHALL:handleImaging Handler
                                                                                                                                                                                          Summaryfalse
                                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                          180. Composition.section.mode
                                                                                                                                                                                          Definition

                                                                                                                                                                                          How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                                                                                                          Shortworking | snapshot | changes
                                                                                                                                                                                          Comments

                                                                                                                                                                                          This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                                                                                                          Control0..1
                                                                                                                                                                                          BindingThe codes SHALL be taken from ListMode
                                                                                                                                                                                          (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                                                                                                          The processing mode that applies to this section.

                                                                                                                                                                                          Typecode
                                                                                                                                                                                          Is Modifierfalse
                                                                                                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                                          Summaryfalse
                                                                                                                                                                                          Requirements

                                                                                                                                                                                          Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                          182. Composition.section.orderedBy
                                                                                                                                                                                          Definition

                                                                                                                                                                                          Specifies the order applied to the items in the section entries.

                                                                                                                                                                                          ShortOrder of section entries
                                                                                                                                                                                          Comments

                                                                                                                                                                                          Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                                                                                                          Control0..1
                                                                                                                                                                                          BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                                                                                                          (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                                                                                                                          What order applies to the items in the entry.

                                                                                                                                                                                          TypeCodeableConcept
                                                                                                                                                                                          Is Modifierfalse
                                                                                                                                                                                          Summaryfalse
                                                                                                                                                                                          Requirements

                                                                                                                                                                                          Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                          184. Composition.section.entry
                                                                                                                                                                                          Definition

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

                                                                                                                                                                                          ShortA reference to data that supports this section
                                                                                                                                                                                          Comments

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

                                                                                                                                                                                          Control0..*
                                                                                                                                                                                          This element is affected by the following invariants: cmp-2
                                                                                                                                                                                          TypeReference(Resource)
                                                                                                                                                                                          Is Modifierfalse
                                                                                                                                                                                          Obligations
                                                                                                                                                                                            ObligationsActor
                                                                                                                                                                                            SHALL:handleImaging Handler
                                                                                                                                                                                            SHALL:handleImaging Handler
                                                                                                                                                                                            Summaryfalse
                                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                            186. Composition.section.emptyReason
                                                                                                                                                                                            Definition

                                                                                                                                                                                            If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                                                                                                            ShortWhy the section is empty
                                                                                                                                                                                            Comments

                                                                                                                                                                                            The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                                                                                                            Control0..1
                                                                                                                                                                                            This element is affected by the following invariants: cmp-2
                                                                                                                                                                                            BindingThe codes SHOULD be taken from Reasons a section in an imaging report is empty.
                                                                                                                                                                                            (preferred to http://fhir.ehdsi.eu/imaging/ValueSet/SectionEmptyReason)
                                                                                                                                                                                            TypeCodeableConcept
                                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                                            Summaryfalse
                                                                                                                                                                                            Requirements

                                                                                                                                                                                            Allows capturing things like "none exist" or "not asked" which can be important for most lists.

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

                                                                                                                                                                                            A nested sub-section within this section.

                                                                                                                                                                                            ShortNested Section
                                                                                                                                                                                            Comments

                                                                                                                                                                                            Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                                                                                                            Control0..*
                                                                                                                                                                                            This element is affected by the following invariants: cmp-1
                                                                                                                                                                                            TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                                            Summaryfalse
                                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                            190. Composition.section:imagingstudy
                                                                                                                                                                                            Slice Nameimagingstudy
                                                                                                                                                                                            Definition

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

                                                                                                                                                                                            ShortImaging Study
                                                                                                                                                                                            Control0..1
                                                                                                                                                                                            TypeBackboneElement
                                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                                            Summaryfalse
                                                                                                                                                                                            Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                                                                                                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                                                                                                            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                            192. Composition.section:imagingstudy.id
                                                                                                                                                                                            Definition

                                                                                                                                                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                                                            ShortUnique id for inter-element referencing
                                                                                                                                                                                            Control0..1
                                                                                                                                                                                            Typestring
                                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                                                            Summaryfalse
                                                                                                                                                                                            194. Composition.section:imagingstudy.extension
                                                                                                                                                                                            Definition

                                                                                                                                                                                            An Extension

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

                                                                                                                                                                                              Additional notes that apply to this resource or element.

                                                                                                                                                                                              ShortAdditional notes that apply to this resource or element.
                                                                                                                                                                                              Comments

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

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

                                                                                                                                                                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                                                                                                                                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                              Comments

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

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

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

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

                                                                                                                                                                                              The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                                                                                                              ShortLabel for section (e.g. for ToC)
                                                                                                                                                                                              Comments

                                                                                                                                                                                              The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                                                                                                              Control0..1
                                                                                                                                                                                              Typestring
                                                                                                                                                                                              Is Modifierfalse
                                                                                                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                                              Obligations
                                                                                                                                                                                                ObligationsActor
                                                                                                                                                                                                SHALL:handleImaging Handler
                                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                                Requirements

                                                                                                                                                                                                Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                                                                                                                Alternate Namesheader, label, caption
                                                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                202. Composition.section:imagingstudy.code
                                                                                                                                                                                                Definition

                                                                                                                                                                                                A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                                                                                                                ShortClassification of section (recommended)
                                                                                                                                                                                                Comments

                                                                                                                                                                                                The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                                                                                                                If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                                                                                                                Control1..1
                                                                                                                                                                                                BindingFor example codes, see DocumentSectionCodes
                                                                                                                                                                                                (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                                                                                                                                Classification of a section of a composition/document.

                                                                                                                                                                                                TypeCodeableConcept
                                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                                Requirements

                                                                                                                                                                                                Provides computable standardized labels to topics within the document.

                                                                                                                                                                                                Pattern Value{
                                                                                                                                                                                                  "coding" : [{
                                                                                                                                                                                                    "system" : "http://loinc.org",
                                                                                                                                                                                                    "code" : "18726-0"
                                                                                                                                                                                                  }]
                                                                                                                                                                                                }
                                                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                204. Composition.section:imagingstudy.author
                                                                                                                                                                                                Definition

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

                                                                                                                                                                                                ShortWho and/or what authored the section
                                                                                                                                                                                                Control0..*
                                                                                                                                                                                                TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                                Requirements

                                                                                                                                                                                                Identifies who is responsible for the content.

                                                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                206. Composition.section:imagingstudy.focus
                                                                                                                                                                                                Definition

                                                                                                                                                                                                The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                                                                                                                ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                                                                                                                Comments

                                                                                                                                                                                                Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                                                                                                                                Control0..1
                                                                                                                                                                                                TypeReference(Resource)
                                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                208. Composition.section:imagingstudy.text
                                                                                                                                                                                                Definition

                                                                                                                                                                                                A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

                                                                                                                                                                                                ShortText summary of the section, for human interpretation
                                                                                                                                                                                                Comments

                                                                                                                                                                                                Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                                                                                                                Control0..1
                                                                                                                                                                                                This element is affected by the following invariants: cmp-1
                                                                                                                                                                                                TypeNarrative
                                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                                Obligations
                                                                                                                                                                                                  ObligationsActor
                                                                                                                                                                                                  SHALL:handleImaging Handler
                                                                                                                                                                                                  Summaryfalse
                                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                  210. Composition.section:imagingstudy.mode
                                                                                                                                                                                                  Definition

                                                                                                                                                                                                  How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                                                                                                                  Shortworking | snapshot | changes
                                                                                                                                                                                                  Comments

                                                                                                                                                                                                  This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                                                                                                                  Control0..1
                                                                                                                                                                                                  BindingThe codes SHALL be taken from ListMode
                                                                                                                                                                                                  (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                                                                                                                  The processing mode that applies to this section.

                                                                                                                                                                                                  Typecode
                                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                                                  Summaryfalse
                                                                                                                                                                                                  Requirements

                                                                                                                                                                                                  Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                  212. Composition.section:imagingstudy.orderedBy
                                                                                                                                                                                                  Definition

                                                                                                                                                                                                  Specifies the order applied to the items in the section entries.

                                                                                                                                                                                                  ShortOrder of section entries
                                                                                                                                                                                                  Comments

                                                                                                                                                                                                  Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                                                                                                                  Control0..1
                                                                                                                                                                                                  BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                                                                                                                  (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                                                                                                                                  What order applies to the items in the entry.

                                                                                                                                                                                                  TypeCodeableConcept
                                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                                  Summaryfalse
                                                                                                                                                                                                  Requirements

                                                                                                                                                                                                  Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                  214. Composition.section:imagingstudy.entry
                                                                                                                                                                                                  Definition

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

                                                                                                                                                                                                  ShortA reference to data that supports this section
                                                                                                                                                                                                  Comments

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

                                                                                                                                                                                                  Control1..*
                                                                                                                                                                                                  This element is affected by the following invariants: cmp-2
                                                                                                                                                                                                  TypeReference(Resource)
                                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                                  Summaryfalse
                                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                  SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                                                  • profile @ $this
                                                                                                                                                                                                  • 216. Composition.section:imagingstudy.entry:imagingstudy
                                                                                                                                                                                                    Slice Nameimagingstudy
                                                                                                                                                                                                    Definition

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

                                                                                                                                                                                                    ShortImaging Study Reference
                                                                                                                                                                                                    Comments

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

                                                                                                                                                                                                    Control1..*
                                                                                                                                                                                                    This element is affected by the following invariants: cmp-2
                                                                                                                                                                                                    TypeReference(Medical Imaging Report Imaging Study)
                                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                                    Summaryfalse
                                                                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                    218. Composition.section:imagingstudy.emptyReason
                                                                                                                                                                                                    Definition

                                                                                                                                                                                                    If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                                                                                                                    ShortWhy the section is empty
                                                                                                                                                                                                    Comments

                                                                                                                                                                                                    The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                                                                                                                    Control0..1
                                                                                                                                                                                                    This element is affected by the following invariants: cmp-2
                                                                                                                                                                                                    BindingThe codes SHOULD be taken from Reasons a section in an imaging report is empty.
                                                                                                                                                                                                    (preferred to http://fhir.ehdsi.eu/imaging/ValueSet/SectionEmptyReason)
                                                                                                                                                                                                    TypeCodeableConcept
                                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                                    Summaryfalse
                                                                                                                                                                                                    Requirements

                                                                                                                                                                                                    Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                    220. Composition.section:imagingstudy.section
                                                                                                                                                                                                    Definition

                                                                                                                                                                                                    A nested sub-section within this section.

                                                                                                                                                                                                    ShortNested Section
                                                                                                                                                                                                    Comments

                                                                                                                                                                                                    Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                                                                                                                    Control0..*
                                                                                                                                                                                                    This element is affected by the following invariants: cmp-1
                                                                                                                                                                                                    TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                                    Summaryfalse
                                                                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                    222. Composition.section:order
                                                                                                                                                                                                    Slice Nameorder
                                                                                                                                                                                                    Definition

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

                                                                                                                                                                                                    ShortOrder
                                                                                                                                                                                                    Control0..1
                                                                                                                                                                                                    TypeBackboneElement
                                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                                    Summaryfalse
                                                                                                                                                                                                    Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                                                                                                                    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                                                                                                                    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                    224. Composition.section:order.id
                                                                                                                                                                                                    Definition

                                                                                                                                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                                                                    ShortUnique id for inter-element referencing
                                                                                                                                                                                                    Control0..1
                                                                                                                                                                                                    Typestring
                                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                                                                    Summaryfalse
                                                                                                                                                                                                    226. Composition.section:order.extension
                                                                                                                                                                                                    Definition

                                                                                                                                                                                                    An Extension

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

                                                                                                                                                                                                      Additional notes that apply to this resource or element.

                                                                                                                                                                                                      ShortAdditional notes that apply to this resource or element.
                                                                                                                                                                                                      Comments

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

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

                                                                                                                                                                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                                                                                                                                                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                      Comments

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

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

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

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

                                                                                                                                                                                                      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                                                                                                                      ShortLabel for section (e.g. for ToC)
                                                                                                                                                                                                      Comments

                                                                                                                                                                                                      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                                                                                                                      Control0..1
                                                                                                                                                                                                      Typestring
                                                                                                                                                                                                      Is Modifierfalse
                                                                                                                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                                                      Obligations
                                                                                                                                                                                                        ObligationsActor
                                                                                                                                                                                                        SHALL:handleImaging Handler
                                                                                                                                                                                                        Summaryfalse
                                                                                                                                                                                                        Requirements

                                                                                                                                                                                                        Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                                                                                                                        Alternate Namesheader, label, caption
                                                                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                        234. Composition.section:order.code
                                                                                                                                                                                                        Definition

                                                                                                                                                                                                        A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                                                                                                                        ShortClassification of section (recommended)
                                                                                                                                                                                                        Comments

                                                                                                                                                                                                        The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                                                                                                                        If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                                                                                                                        Control1..1
                                                                                                                                                                                                        BindingFor example codes, see DocumentSectionCodes
                                                                                                                                                                                                        (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                                                                                                                                        Classification of a section of a composition/document.

                                                                                                                                                                                                        TypeCodeableConcept
                                                                                                                                                                                                        Is Modifierfalse
                                                                                                                                                                                                        Summaryfalse
                                                                                                                                                                                                        Requirements

                                                                                                                                                                                                        Provides computable standardized labels to topics within the document.

                                                                                                                                                                                                        Pattern Value{
                                                                                                                                                                                                          "coding" : [{
                                                                                                                                                                                                            "system" : "http://loinc.org",
                                                                                                                                                                                                            "code" : "55115-0",
                                                                                                                                                                                                            "display" : "Requested imaging studies information Document"
                                                                                                                                                                                                          }]
                                                                                                                                                                                                        }
                                                                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                        236. Composition.section:order.author
                                                                                                                                                                                                        Definition

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

                                                                                                                                                                                                        ShortWho and/or what authored the section
                                                                                                                                                                                                        Control0..*
                                                                                                                                                                                                        TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                                                                                                                        Is Modifierfalse
                                                                                                                                                                                                        Summaryfalse
                                                                                                                                                                                                        Requirements

                                                                                                                                                                                                        Identifies who is responsible for the content.

                                                                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                        238. Composition.section:order.focus
                                                                                                                                                                                                        Definition

                                                                                                                                                                                                        The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                                                                                                                        ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                                                                                                                        Comments

                                                                                                                                                                                                        Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                                                                                                                                        Control0..1
                                                                                                                                                                                                        TypeReference(Resource)
                                                                                                                                                                                                        Is Modifierfalse
                                                                                                                                                                                                        Summaryfalse
                                                                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                        240. Composition.section:order.text
                                                                                                                                                                                                        Definition

                                                                                                                                                                                                        A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

                                                                                                                                                                                                        ShortText summary of the section, for human interpretation
                                                                                                                                                                                                        Comments

                                                                                                                                                                                                        Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                                                                                                                        Control0..1
                                                                                                                                                                                                        This element is affected by the following invariants: cmp-1
                                                                                                                                                                                                        TypeNarrative
                                                                                                                                                                                                        Is Modifierfalse
                                                                                                                                                                                                        Obligations
                                                                                                                                                                                                          ObligationsActor
                                                                                                                                                                                                          SHALL:handleImaging Handler
                                                                                                                                                                                                          Summaryfalse
                                                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                          242. Composition.section:order.mode
                                                                                                                                                                                                          Definition

                                                                                                                                                                                                          How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                                                                                                                          Shortworking | snapshot | changes
                                                                                                                                                                                                          Comments

                                                                                                                                                                                                          This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                                                                                                                          Control0..1
                                                                                                                                                                                                          BindingThe codes SHALL be taken from ListMode
                                                                                                                                                                                                          (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                                                                                                                          The processing mode that applies to this section.

                                                                                                                                                                                                          Typecode
                                                                                                                                                                                                          Is Modifierfalse
                                                                                                                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                                                          Summaryfalse
                                                                                                                                                                                                          Requirements

                                                                                                                                                                                                          Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                          244. Composition.section:order.orderedBy
                                                                                                                                                                                                          Definition

                                                                                                                                                                                                          Specifies the order applied to the items in the section entries.

                                                                                                                                                                                                          ShortOrder of section entries
                                                                                                                                                                                                          Comments

                                                                                                                                                                                                          Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                                                                                                                          Control0..1
                                                                                                                                                                                                          BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                                                                                                                          (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                                                                                                                                          What order applies to the items in the entry.

                                                                                                                                                                                                          TypeCodeableConcept
                                                                                                                                                                                                          Is Modifierfalse
                                                                                                                                                                                                          Summaryfalse
                                                                                                                                                                                                          Requirements

                                                                                                                                                                                                          Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                          246. Composition.section:order.entry
                                                                                                                                                                                                          Definition

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

                                                                                                                                                                                                          ShortA reference to data that supports this section
                                                                                                                                                                                                          Comments

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

                                                                                                                                                                                                          Control0..*
                                                                                                                                                                                                          This element is affected by the following invariants: cmp-2
                                                                                                                                                                                                          TypeReference(Resource)
                                                                                                                                                                                                          Is Modifierfalse
                                                                                                                                                                                                          Summaryfalse
                                                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                          SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                                                          • profile @ $this
                                                                                                                                                                                                          • 248. Composition.section:order.entry:order
                                                                                                                                                                                                            Slice Nameorder
                                                                                                                                                                                                            Definition

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

                                                                                                                                                                                                            ShortOrder reference
                                                                                                                                                                                                            Comments

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

                                                                                                                                                                                                            Control0..*
                                                                                                                                                                                                            This element is affected by the following invariants: cmp-2
                                                                                                                                                                                                            TypeReference(ServiceRequest: Imaging)
                                                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                                                            Summaryfalse
                                                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                            250. Composition.section:order.emptyReason
                                                                                                                                                                                                            Definition

                                                                                                                                                                                                            If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                                                                                                                            ShortWhy the section is empty
                                                                                                                                                                                                            Comments

                                                                                                                                                                                                            The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                                                                                                                            Control0..1
                                                                                                                                                                                                            This element is affected by the following invariants: cmp-2
                                                                                                                                                                                                            BindingThe codes SHOULD be taken from Reasons a section in an imaging report is empty.
                                                                                                                                                                                                            (preferred to http://fhir.ehdsi.eu/imaging/ValueSet/SectionEmptyReason)
                                                                                                                                                                                                            TypeCodeableConcept
                                                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                                                            Summaryfalse
                                                                                                                                                                                                            Requirements

                                                                                                                                                                                                            Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                            252. Composition.section:order.section
                                                                                                                                                                                                            Definition

                                                                                                                                                                                                            A nested sub-section within this section.

                                                                                                                                                                                                            ShortNested Section
                                                                                                                                                                                                            Comments

                                                                                                                                                                                                            Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                                                                                                                            Control0..*
                                                                                                                                                                                                            This element is affected by the following invariants: cmp-1
                                                                                                                                                                                                            TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                                                            Summaryfalse
                                                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                            254. Composition.section:history
                                                                                                                                                                                                            Slice Namehistory
                                                                                                                                                                                                            Definition

                                                                                                                                                                                                            The root of the sections that make up the composition.

                                                                                                                                                                                                            ShortHistory
                                                                                                                                                                                                            Control0..1
                                                                                                                                                                                                            TypeBackboneElement
                                                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                                                            Summaryfalse
                                                                                                                                                                                                            Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                                                                                                                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                                                                                                                            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                            256. Composition.section:history.id
                                                                                                                                                                                                            Definition

                                                                                                                                                                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                                                                            ShortUnique id for inter-element referencing
                                                                                                                                                                                                            Control0..1
                                                                                                                                                                                                            Typestring
                                                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                                                                            Summaryfalse
                                                                                                                                                                                                            258. Composition.section:history.extension
                                                                                                                                                                                                            Definition

                                                                                                                                                                                                            An Extension

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

                                                                                                                                                                                                              Additional notes that apply to this resource or element.

                                                                                                                                                                                                              ShortAdditional notes that apply to this resource or element.
                                                                                                                                                                                                              Comments

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

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

                                                                                                                                                                                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                                                                                                                                                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                              Comments

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

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

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

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

                                                                                                                                                                                                              The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                                                                                                                              ShortLabel for section (e.g. for ToC)
                                                                                                                                                                                                              Comments

                                                                                                                                                                                                              The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                                                                                                                              Control0..1
                                                                                                                                                                                                              Typestring
                                                                                                                                                                                                              Is Modifierfalse
                                                                                                                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                                                              Obligations
                                                                                                                                                                                                                ObligationsActor
                                                                                                                                                                                                                SHALL:handleImaging Handler
                                                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                                                Requirements

                                                                                                                                                                                                                Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                                                                                                                                Alternate Namesheader, label, caption
                                                                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                266. Composition.section:history.code
                                                                                                                                                                                                                Definition

                                                                                                                                                                                                                A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                                                                                                                                ShortClassification of section (recommended)
                                                                                                                                                                                                                Comments

                                                                                                                                                                                                                The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                                                                                                                                If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                                                                                                                                Control1..1
                                                                                                                                                                                                                BindingFor example codes, see DocumentSectionCodes
                                                                                                                                                                                                                (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                                                                                                                                                Classification of a section of a composition/document.

                                                                                                                                                                                                                TypeCodeableConcept
                                                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                                                Requirements

                                                                                                                                                                                                                Provides computable standardized labels to topics within the document.

                                                                                                                                                                                                                Pattern Value{
                                                                                                                                                                                                                  "coding" : [{
                                                                                                                                                                                                                    "system" : "http://loinc.org",
                                                                                                                                                                                                                    "code" : "11329-0",
                                                                                                                                                                                                                    "display" : "History general Narrative - Reported"
                                                                                                                                                                                                                  }]
                                                                                                                                                                                                                }
                                                                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                268. Composition.section:history.author
                                                                                                                                                                                                                Definition

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

                                                                                                                                                                                                                ShortWho and/or what authored the section
                                                                                                                                                                                                                Control0..*
                                                                                                                                                                                                                TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                                                Requirements

                                                                                                                                                                                                                Identifies who is responsible for the content.

                                                                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                270. Composition.section:history.focus
                                                                                                                                                                                                                Definition

                                                                                                                                                                                                                The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                                                                                                                                ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                                                                                                                                Comments

                                                                                                                                                                                                                Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                                                                                                                                                Control0..1
                                                                                                                                                                                                                TypeReference(Resource)
                                                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                272. Composition.section:history.text
                                                                                                                                                                                                                Definition

                                                                                                                                                                                                                A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

                                                                                                                                                                                                                ShortText summary of the section, for human interpretation
                                                                                                                                                                                                                Comments

                                                                                                                                                                                                                Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                                                                                                                                Control0..1
                                                                                                                                                                                                                This element is affected by the following invariants: cmp-1
                                                                                                                                                                                                                TypeNarrative
                                                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                                                Obligations
                                                                                                                                                                                                                  ObligationsActor
                                                                                                                                                                                                                  SHALL:handleImaging Handler
                                                                                                                                                                                                                  Summaryfalse
                                                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                  274. Composition.section:history.mode
                                                                                                                                                                                                                  Definition

                                                                                                                                                                                                                  How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                                                                                                                                  Shortworking | snapshot | changes
                                                                                                                                                                                                                  Comments

                                                                                                                                                                                                                  This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                                                                                                                                  Control0..1
                                                                                                                                                                                                                  BindingThe codes SHALL be taken from ListMode
                                                                                                                                                                                                                  (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                                                                                                                                  The processing mode that applies to this section.

                                                                                                                                                                                                                  Typecode
                                                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                                                                  Summaryfalse
                                                                                                                                                                                                                  Requirements

                                                                                                                                                                                                                  Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                  276. Composition.section:history.orderedBy
                                                                                                                                                                                                                  Definition

                                                                                                                                                                                                                  Specifies the order applied to the items in the section entries.

                                                                                                                                                                                                                  ShortOrder of section entries
                                                                                                                                                                                                                  Comments

                                                                                                                                                                                                                  Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                                                                                                                                  Control0..1
                                                                                                                                                                                                                  BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                                                                                                                                  (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                                                                                                                                                  What order applies to the items in the entry.

                                                                                                                                                                                                                  TypeCodeableConcept
                                                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                                                  Summaryfalse
                                                                                                                                                                                                                  Requirements

                                                                                                                                                                                                                  Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                  278. Composition.section:history.entry
                                                                                                                                                                                                                  Definition

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

                                                                                                                                                                                                                  ShortA reference to data that supports this section
                                                                                                                                                                                                                  Comments

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

                                                                                                                                                                                                                  Control0..*
                                                                                                                                                                                                                  This element is affected by the following invariants: cmp-2
                                                                                                                                                                                                                  TypeReference(Resource)
                                                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                                                  Obligations
                                                                                                                                                                                                                    ObligationsActor
                                                                                                                                                                                                                    SHALL:handleImaging Handler
                                                                                                                                                                                                                    SHALL:handleImaging Handler
                                                                                                                                                                                                                    Summaryfalse
                                                                                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                    280. Composition.section:history.emptyReason
                                                                                                                                                                                                                    Definition

                                                                                                                                                                                                                    If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                                                                                                                                    ShortWhy the section is empty
                                                                                                                                                                                                                    Comments

                                                                                                                                                                                                                    The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                                                                                                                                    Control0..1
                                                                                                                                                                                                                    This element is affected by the following invariants: cmp-2
                                                                                                                                                                                                                    BindingThe codes SHOULD be taken from Reasons a section in an imaging report is empty.
                                                                                                                                                                                                                    (preferred to http://fhir.ehdsi.eu/imaging/ValueSet/SectionEmptyReason)
                                                                                                                                                                                                                    TypeCodeableConcept
                                                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                                                    Summaryfalse
                                                                                                                                                                                                                    Requirements

                                                                                                                                                                                                                    Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                    282. Composition.section:history.section
                                                                                                                                                                                                                    Definition

                                                                                                                                                                                                                    A nested sub-section within this section.

                                                                                                                                                                                                                    ShortNested Section
                                                                                                                                                                                                                    Comments

                                                                                                                                                                                                                    Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                                                                                                                                    Control0..*
                                                                                                                                                                                                                    This element is affected by the following invariants: cmp-1
                                                                                                                                                                                                                    TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                                                    Summaryfalse
                                                                                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                    284. Composition.section:procedure
                                                                                                                                                                                                                    Slice Nameprocedure
                                                                                                                                                                                                                    Definition

                                                                                                                                                                                                                    The root of the sections that make up the composition.

                                                                                                                                                                                                                    ShortProcedure
                                                                                                                                                                                                                    Control0..1
                                                                                                                                                                                                                    TypeBackboneElement
                                                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                                                    Summaryfalse
                                                                                                                                                                                                                    Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                                                                                                                                    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                                                                                                                                    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                    286. Composition.section:procedure.id
                                                                                                                                                                                                                    Definition

                                                                                                                                                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                                                                                    ShortUnique id for inter-element referencing
                                                                                                                                                                                                                    Control0..1
                                                                                                                                                                                                                    Typestring
                                                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                                                                                    Summaryfalse
                                                                                                                                                                                                                    288. Composition.section:procedure.extension
                                                                                                                                                                                                                    Definition

                                                                                                                                                                                                                    An Extension

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

                                                                                                                                                                                                                      Additional notes that apply to this resource or element.

                                                                                                                                                                                                                      ShortAdditional notes that apply to this resource or element.
                                                                                                                                                                                                                      Comments

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

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

                                                                                                                                                                                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                                                                                                                                                                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                      Comments

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

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

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

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

                                                                                                                                                                                                                      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                                                                                                                                      ShortLabel for section (e.g. for ToC)
                                                                                                                                                                                                                      Comments

                                                                                                                                                                                                                      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                                                                                                                                      Control0..1
                                                                                                                                                                                                                      Typestring
                                                                                                                                                                                                                      Is Modifierfalse
                                                                                                                                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                                                                      Obligations
                                                                                                                                                                                                                        ObligationsActor
                                                                                                                                                                                                                        SHALL:handleImaging Handler
                                                                                                                                                                                                                        Summaryfalse
                                                                                                                                                                                                                        Requirements

                                                                                                                                                                                                                        Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                                                                                                                                        Alternate Namesheader, label, caption
                                                                                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                        296. Composition.section:procedure.code
                                                                                                                                                                                                                        Definition

                                                                                                                                                                                                                        A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                                                                                                                                        ShortClassification of section (recommended)
                                                                                                                                                                                                                        Comments

                                                                                                                                                                                                                        The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                                                                                                                                        If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                                                                                                                                        Control1..1
                                                                                                                                                                                                                        BindingFor example codes, see DocumentSectionCodes
                                                                                                                                                                                                                        (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                                                                                                                                                        Classification of a section of a composition/document.

                                                                                                                                                                                                                        TypeCodeableConcept
                                                                                                                                                                                                                        Is Modifierfalse
                                                                                                                                                                                                                        Summaryfalse
                                                                                                                                                                                                                        Requirements

                                                                                                                                                                                                                        Provides computable standardized labels to topics within the document.

                                                                                                                                                                                                                        Pattern Value{
                                                                                                                                                                                                                          "coding" : [{
                                                                                                                                                                                                                            "system" : "http://loinc.org",
                                                                                                                                                                                                                            "code" : "55111-9",
                                                                                                                                                                                                                            "display" : "Current imaging procedure descriptions Document"
                                                                                                                                                                                                                          }]
                                                                                                                                                                                                                        }
                                                                                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                        298. Composition.section:procedure.author
                                                                                                                                                                                                                        Definition

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

                                                                                                                                                                                                                        ShortWho and/or what authored the section
                                                                                                                                                                                                                        Control0..*
                                                                                                                                                                                                                        TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                                                                                                                                        Is Modifierfalse
                                                                                                                                                                                                                        Summaryfalse
                                                                                                                                                                                                                        Requirements

                                                                                                                                                                                                                        Identifies who is responsible for the content.

                                                                                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                        300. Composition.section:procedure.focus
                                                                                                                                                                                                                        Definition

                                                                                                                                                                                                                        The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                                                                                                                                        ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                                                                                                                                        Comments

                                                                                                                                                                                                                        Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                                                                                                                                                        Control0..1
                                                                                                                                                                                                                        TypeReference(Resource)
                                                                                                                                                                                                                        Is Modifierfalse
                                                                                                                                                                                                                        Summaryfalse
                                                                                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                        302. Composition.section:procedure.text
                                                                                                                                                                                                                        Definition

                                                                                                                                                                                                                        A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

                                                                                                                                                                                                                        ShortText summary of the section, for human interpretation
                                                                                                                                                                                                                        Comments

                                                                                                                                                                                                                        Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                                                                                                                                        Control0..1
                                                                                                                                                                                                                        This element is affected by the following invariants: cmp-1
                                                                                                                                                                                                                        TypeNarrative
                                                                                                                                                                                                                        Is Modifierfalse
                                                                                                                                                                                                                        Obligations
                                                                                                                                                                                                                          ObligationsActor
                                                                                                                                                                                                                          SHALL:handleImaging Handler
                                                                                                                                                                                                                          Summaryfalse
                                                                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                          304. Composition.section:procedure.mode
                                                                                                                                                                                                                          Definition

                                                                                                                                                                                                                          How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                                                                                                                                          Shortworking | snapshot | changes
                                                                                                                                                                                                                          Comments

                                                                                                                                                                                                                          This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                                                                                                                                          Control0..1
                                                                                                                                                                                                                          BindingThe codes SHALL be taken from ListMode
                                                                                                                                                                                                                          (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                                                                                                                                          The processing mode that applies to this section.

                                                                                                                                                                                                                          Typecode
                                                                                                                                                                                                                          Is Modifierfalse
                                                                                                                                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                                                                          Summaryfalse
                                                                                                                                                                                                                          Requirements

                                                                                                                                                                                                                          Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                          306. Composition.section:procedure.orderedBy
                                                                                                                                                                                                                          Definition

                                                                                                                                                                                                                          Specifies the order applied to the items in the section entries.

                                                                                                                                                                                                                          ShortOrder of section entries
                                                                                                                                                                                                                          Comments

                                                                                                                                                                                                                          Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                                                                                                                                          Control0..1
                                                                                                                                                                                                                          BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                                                                                                                                          (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                                                                                                                                                          What order applies to the items in the entry.

                                                                                                                                                                                                                          TypeCodeableConcept
                                                                                                                                                                                                                          Is Modifierfalse
                                                                                                                                                                                                                          Summaryfalse
                                                                                                                                                                                                                          Requirements

                                                                                                                                                                                                                          Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                          308. Composition.section:procedure.entry
                                                                                                                                                                                                                          Definition

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

                                                                                                                                                                                                                          ShortA reference to data that supports this section
                                                                                                                                                                                                                          Comments

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

                                                                                                                                                                                                                          Control0..*
                                                                                                                                                                                                                          This element is affected by the following invariants: cmp-2
                                                                                                                                                                                                                          TypeReference(Resource)
                                                                                                                                                                                                                          Is Modifierfalse
                                                                                                                                                                                                                          Summaryfalse
                                                                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                          SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                                                                          • profile @ $this
                                                                                                                                                                                                                          • 310. Composition.section:procedure.entry:procedure
                                                                                                                                                                                                                            Slice Nameprocedure
                                                                                                                                                                                                                            Definition

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

                                                                                                                                                                                                                            ShortA reference to data that supports this section
                                                                                                                                                                                                                            Comments

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

                                                                                                                                                                                                                            Control0..*
                                                                                                                                                                                                                            This element is affected by the following invariants: cmp-2
                                                                                                                                                                                                                            TypeReference(Procedure)
                                                                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                                                                            Summaryfalse
                                                                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                            312. Composition.section:procedure.emptyReason
                                                                                                                                                                                                                            Definition

                                                                                                                                                                                                                            If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                                                                                                                                            ShortWhy the section is empty
                                                                                                                                                                                                                            Comments

                                                                                                                                                                                                                            The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                                                                                                                                            Control0..1
                                                                                                                                                                                                                            This element is affected by the following invariants: cmp-2
                                                                                                                                                                                                                            BindingThe codes SHOULD be taken from Reasons a section in an imaging report is empty.
                                                                                                                                                                                                                            (preferred to http://fhir.ehdsi.eu/imaging/ValueSet/SectionEmptyReason)
                                                                                                                                                                                                                            TypeCodeableConcept
                                                                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                                                                            Summaryfalse
                                                                                                                                                                                                                            Requirements

                                                                                                                                                                                                                            Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                            314. Composition.section:procedure.section
                                                                                                                                                                                                                            Definition

                                                                                                                                                                                                                            A nested sub-section within this section.

                                                                                                                                                                                                                            ShortNested Section
                                                                                                                                                                                                                            Comments

                                                                                                                                                                                                                            Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                                                                                                                                            Control0..*
                                                                                                                                                                                                                            This element is affected by the following invariants: cmp-1
                                                                                                                                                                                                                            TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                                                                            Summaryfalse
                                                                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                            316. Composition.section:comparison
                                                                                                                                                                                                                            Slice Namecomparison
                                                                                                                                                                                                                            Definition

                                                                                                                                                                                                                            The root of the sections that make up the composition.

                                                                                                                                                                                                                            ShortHistory
                                                                                                                                                                                                                            Control0..1
                                                                                                                                                                                                                            TypeBackboneElement
                                                                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                                                                            Summaryfalse
                                                                                                                                                                                                                            Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                                                                                                                                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                                                                                                                                            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                            318. Composition.section:comparison.id
                                                                                                                                                                                                                            Definition

                                                                                                                                                                                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                                                                                            ShortUnique id for inter-element referencing
                                                                                                                                                                                                                            Control0..1
                                                                                                                                                                                                                            Typestring
                                                                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                                                                                            Summaryfalse
                                                                                                                                                                                                                            320. Composition.section:comparison.extension
                                                                                                                                                                                                                            Definition

                                                                                                                                                                                                                            An Extension

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

                                                                                                                                                                                                                              Additional notes that apply to this resource or element.

                                                                                                                                                                                                                              ShortAdditional notes that apply to this resource or element.
                                                                                                                                                                                                                              Comments

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

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

                                                                                                                                                                                                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                                                                                                                                                                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                              Comments

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

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

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

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

                                                                                                                                                                                                                              The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                                                                                                                                              ShortLabel for section (e.g. for ToC)
                                                                                                                                                                                                                              Comments

                                                                                                                                                                                                                              The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                                                                                                                                              Control0..1
                                                                                                                                                                                                                              Typestring
                                                                                                                                                                                                                              Is Modifierfalse
                                                                                                                                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                                                                              Obligations
                                                                                                                                                                                                                                ObligationsActor
                                                                                                                                                                                                                                SHALL:handleImaging Handler
                                                                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                                                                Requirements

                                                                                                                                                                                                                                Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                                                                                                                                                Alternate Namesheader, label, caption
                                                                                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                328. Composition.section:comparison.code
                                                                                                                                                                                                                                Definition

                                                                                                                                                                                                                                A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                                                                                                                                                ShortClassification of section (recommended)
                                                                                                                                                                                                                                Comments

                                                                                                                                                                                                                                The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                                                                                                                                                If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                                                                                                                                                Control1..1
                                                                                                                                                                                                                                BindingFor example codes, see DocumentSectionCodes
                                                                                                                                                                                                                                (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                                                                                                                                                                Classification of a section of a composition/document.

                                                                                                                                                                                                                                TypeCodeableConcept
                                                                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                                                                Requirements

                                                                                                                                                                                                                                Provides computable standardized labels to topics within the document.

                                                                                                                                                                                                                                Pattern Value{
                                                                                                                                                                                                                                  "coding" : [{
                                                                                                                                                                                                                                    "system" : "http://loinc.org",
                                                                                                                                                                                                                                    "code" : "18834-2",
                                                                                                                                                                                                                                    "display" : "Radiology Comparison study (narrative)"
                                                                                                                                                                                                                                  }]
                                                                                                                                                                                                                                }
                                                                                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                330. Composition.section:comparison.author
                                                                                                                                                                                                                                Definition

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

                                                                                                                                                                                                                                ShortWho and/or what authored the section
                                                                                                                                                                                                                                Control0..*
                                                                                                                                                                                                                                TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                                                                Requirements

                                                                                                                                                                                                                                Identifies who is responsible for the content.

                                                                                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                332. Composition.section:comparison.focus
                                                                                                                                                                                                                                Definition

                                                                                                                                                                                                                                The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                                                                                                                                                ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                                                                                                                                                Comments

                                                                                                                                                                                                                                Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                                                                                                                                                                Control0..1
                                                                                                                                                                                                                                TypeReference(Resource)
                                                                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                334. Composition.section:comparison.text
                                                                                                                                                                                                                                Definition

                                                                                                                                                                                                                                A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

                                                                                                                                                                                                                                ShortText summary of the section, for human interpretation
                                                                                                                                                                                                                                Comments

                                                                                                                                                                                                                                Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                                                                                                                                                Control0..1
                                                                                                                                                                                                                                This element is affected by the following invariants: cmp-1
                                                                                                                                                                                                                                TypeNarrative
                                                                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                                                                Obligations
                                                                                                                                                                                                                                  ObligationsActor
                                                                                                                                                                                                                                  SHALL:handleImaging Handler
                                                                                                                                                                                                                                  Summaryfalse
                                                                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                  336. Composition.section:comparison.mode
                                                                                                                                                                                                                                  Definition

                                                                                                                                                                                                                                  How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                                                                                                                                                  Shortworking | snapshot | changes
                                                                                                                                                                                                                                  Comments

                                                                                                                                                                                                                                  This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                                                                                                                                                  Control0..1
                                                                                                                                                                                                                                  BindingThe codes SHALL be taken from ListMode
                                                                                                                                                                                                                                  (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                                                                                                                                                  The processing mode that applies to this section.

                                                                                                                                                                                                                                  Typecode
                                                                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                                                                                  Summaryfalse
                                                                                                                                                                                                                                  Requirements

                                                                                                                                                                                                                                  Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                  338. Composition.section:comparison.orderedBy
                                                                                                                                                                                                                                  Definition

                                                                                                                                                                                                                                  Specifies the order applied to the items in the section entries.

                                                                                                                                                                                                                                  ShortOrder of section entries
                                                                                                                                                                                                                                  Comments

                                                                                                                                                                                                                                  Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                                                                                                                                                  Control0..1
                                                                                                                                                                                                                                  BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                                                                                                                                                  (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                                                                                                                                                                  What order applies to the items in the entry.

                                                                                                                                                                                                                                  TypeCodeableConcept
                                                                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                                                                  Summaryfalse
                                                                                                                                                                                                                                  Requirements

                                                                                                                                                                                                                                  Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                  340. Composition.section:comparison.entry
                                                                                                                                                                                                                                  Definition

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

                                                                                                                                                                                                                                  ShortA reference to data that supports this section
                                                                                                                                                                                                                                  Comments

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

                                                                                                                                                                                                                                  Control0..*
                                                                                                                                                                                                                                  This element is affected by the following invariants: cmp-2
                                                                                                                                                                                                                                  TypeReference(Resource)
                                                                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                                                                  Summaryfalse
                                                                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                  SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                                                                                  • profile @ $this
                                                                                                                                                                                                                                  • 342. Composition.section:comparison.entry:comparedstudy
                                                                                                                                                                                                                                    Slice Namecomparedstudy
                                                                                                                                                                                                                                    Definition

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

                                                                                                                                                                                                                                    ShortA reference to data that supports this section
                                                                                                                                                                                                                                    Comments

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

                                                                                                                                                                                                                                    Control0..*
                                                                                                                                                                                                                                    This element is affected by the following invariants: cmp-2
                                                                                                                                                                                                                                    TypeReference(ImagingStudy)
                                                                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                                                                    Summaryfalse
                                                                                                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                    344. Composition.section:comparison.emptyReason
                                                                                                                                                                                                                                    Definition

                                                                                                                                                                                                                                    If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                                                                                                                                                    ShortWhy the section is empty
                                                                                                                                                                                                                                    Comments

                                                                                                                                                                                                                                    The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                                                                                                                                                    Control0..1
                                                                                                                                                                                                                                    This element is affected by the following invariants: cmp-2
                                                                                                                                                                                                                                    BindingThe codes SHOULD be taken from Reasons a section in an imaging report is empty.
                                                                                                                                                                                                                                    (preferred to http://fhir.ehdsi.eu/imaging/ValueSet/SectionEmptyReason)
                                                                                                                                                                                                                                    TypeCodeableConcept
                                                                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                                                                    Summaryfalse
                                                                                                                                                                                                                                    Requirements

                                                                                                                                                                                                                                    Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                    346. Composition.section:comparison.section
                                                                                                                                                                                                                                    Definition

                                                                                                                                                                                                                                    A nested sub-section within this section.

                                                                                                                                                                                                                                    ShortNested Section
                                                                                                                                                                                                                                    Comments

                                                                                                                                                                                                                                    Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                                                                                                                                                    Control0..*
                                                                                                                                                                                                                                    This element is affected by the following invariants: cmp-1
                                                                                                                                                                                                                                    TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                                                                    Summaryfalse
                                                                                                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                    348. Composition.section:findings
                                                                                                                                                                                                                                    Slice Namefindings
                                                                                                                                                                                                                                    Definition

                                                                                                                                                                                                                                    The root of the sections that make up the composition.

                                                                                                                                                                                                                                    ShortFindings
                                                                                                                                                                                                                                    Control1..1
                                                                                                                                                                                                                                    TypeBackboneElement
                                                                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                                                                    Summaryfalse
                                                                                                                                                                                                                                    Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                                                                                                                                                    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                                                                                                                                                    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                    350. Composition.section:findings.id
                                                                                                                                                                                                                                    Definition

                                                                                                                                                                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                                                                                                    ShortUnique id for inter-element referencing
                                                                                                                                                                                                                                    Control0..1
                                                                                                                                                                                                                                    Typestring
                                                                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                                                                                                    Summaryfalse
                                                                                                                                                                                                                                    352. Composition.section:findings.extension
                                                                                                                                                                                                                                    Definition

                                                                                                                                                                                                                                    An Extension

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

                                                                                                                                                                                                                                      Additional notes that apply to this resource or element.

                                                                                                                                                                                                                                      ShortAdditional notes that apply to this resource or element.
                                                                                                                                                                                                                                      Comments

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

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

                                                                                                                                                                                                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                                                                                                                                                                                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                      Comments

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

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

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

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

                                                                                                                                                                                                                                      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                                                                                                                                                      ShortLabel for section (e.g. for ToC)
                                                                                                                                                                                                                                      Comments

                                                                                                                                                                                                                                      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                                                                                                                                                      Control0..1
                                                                                                                                                                                                                                      Typestring
                                                                                                                                                                                                                                      Is Modifierfalse
                                                                                                                                                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                                                                                      Obligations
                                                                                                                                                                                                                                        ObligationsActor
                                                                                                                                                                                                                                        SHALL:handleImaging Handler
                                                                                                                                                                                                                                        Summaryfalse
                                                                                                                                                                                                                                        Requirements

                                                                                                                                                                                                                                        Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                                                                                                                                                        Alternate Namesheader, label, caption
                                                                                                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                        360. Composition.section:findings.code
                                                                                                                                                                                                                                        Definition

                                                                                                                                                                                                                                        A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                                                                                                                                                        ShortClassification of section (recommended)
                                                                                                                                                                                                                                        Comments

                                                                                                                                                                                                                                        The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                                                                                                                                                        If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                                                                                                                                                        Control1..1
                                                                                                                                                                                                                                        BindingFor example codes, see DocumentSectionCodes
                                                                                                                                                                                                                                        (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                                                                                                                                                                        Classification of a section of a composition/document.

                                                                                                                                                                                                                                        TypeCodeableConcept
                                                                                                                                                                                                                                        Is Modifierfalse
                                                                                                                                                                                                                                        Summaryfalse
                                                                                                                                                                                                                                        Requirements

                                                                                                                                                                                                                                        Provides computable standardized labels to topics within the document.

                                                                                                                                                                                                                                        Pattern Value{
                                                                                                                                                                                                                                          "coding" : [{
                                                                                                                                                                                                                                            "system" : "http://loinc.org",
                                                                                                                                                                                                                                            "code" : "59776-5",
                                                                                                                                                                                                                                            "display" : "Findings"
                                                                                                                                                                                                                                          }]
                                                                                                                                                                                                                                        }
                                                                                                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                        362. Composition.section:findings.author
                                                                                                                                                                                                                                        Definition

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

                                                                                                                                                                                                                                        ShortWho and/or what authored the section
                                                                                                                                                                                                                                        Control0..*
                                                                                                                                                                                                                                        TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                                                                                                                                                        Is Modifierfalse
                                                                                                                                                                                                                                        Summaryfalse
                                                                                                                                                                                                                                        Requirements

                                                                                                                                                                                                                                        Identifies who is responsible for the content.

                                                                                                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                        364. Composition.section:findings.focus
                                                                                                                                                                                                                                        Definition

                                                                                                                                                                                                                                        The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                                                                                                                                                        ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                                                                                                                                                        Comments

                                                                                                                                                                                                                                        Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                                                                                                                                                                        Control0..1
                                                                                                                                                                                                                                        TypeReference(Resource)
                                                                                                                                                                                                                                        Is Modifierfalse
                                                                                                                                                                                                                                        Summaryfalse
                                                                                                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                        366. Composition.section:findings.text
                                                                                                                                                                                                                                        Definition

                                                                                                                                                                                                                                        A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

                                                                                                                                                                                                                                        ShortText summary of the section, for human interpretation
                                                                                                                                                                                                                                        Comments

                                                                                                                                                                                                                                        Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                                                                                                                                                        Control0..1
                                                                                                                                                                                                                                        This element is affected by the following invariants: cmp-1
                                                                                                                                                                                                                                        TypeNarrative
                                                                                                                                                                                                                                        Is Modifierfalse
                                                                                                                                                                                                                                        Obligations
                                                                                                                                                                                                                                          ObligationsActor
                                                                                                                                                                                                                                          SHALL:handleImaging Handler
                                                                                                                                                                                                                                          Summaryfalse
                                                                                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                          368. Composition.section:findings.mode
                                                                                                                                                                                                                                          Definition

                                                                                                                                                                                                                                          How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                                                                                                                                                          Shortworking | snapshot | changes
                                                                                                                                                                                                                                          Comments

                                                                                                                                                                                                                                          This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                                                                                                                                                          Control0..1
                                                                                                                                                                                                                                          BindingThe codes SHALL be taken from ListMode
                                                                                                                                                                                                                                          (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                                                                                                                                                          The processing mode that applies to this section.

                                                                                                                                                                                                                                          Typecode
                                                                                                                                                                                                                                          Is Modifierfalse
                                                                                                                                                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                                                                                          Summaryfalse
                                                                                                                                                                                                                                          Requirements

                                                                                                                                                                                                                                          Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                          370. Composition.section:findings.orderedBy
                                                                                                                                                                                                                                          Definition

                                                                                                                                                                                                                                          Specifies the order applied to the items in the section entries.

                                                                                                                                                                                                                                          ShortOrder of section entries
                                                                                                                                                                                                                                          Comments

                                                                                                                                                                                                                                          Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                                                                                                                                                          Control0..1
                                                                                                                                                                                                                                          BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                                                                                                                                                          (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                                                                                                                                                                          What order applies to the items in the entry.

                                                                                                                                                                                                                                          TypeCodeableConcept
                                                                                                                                                                                                                                          Is Modifierfalse
                                                                                                                                                                                                                                          Summaryfalse
                                                                                                                                                                                                                                          Requirements

                                                                                                                                                                                                                                          Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                          372. Composition.section:findings.entry
                                                                                                                                                                                                                                          Definition

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

                                                                                                                                                                                                                                          ShortA reference to data that supports this section
                                                                                                                                                                                                                                          Comments

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

                                                                                                                                                                                                                                          Control0..*
                                                                                                                                                                                                                                          This element is affected by the following invariants: cmp-2
                                                                                                                                                                                                                                          TypeReference(Resource)
                                                                                                                                                                                                                                          Is Modifierfalse
                                                                                                                                                                                                                                          Summaryfalse
                                                                                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                          SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                                                                                          • profile @ $this
                                                                                                                                                                                                                                          • 374. Composition.section:findings.entry:finding
                                                                                                                                                                                                                                            Slice Namefinding
                                                                                                                                                                                                                                            Definition

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

                                                                                                                                                                                                                                            ShortA reference to data that supports this section
                                                                                                                                                                                                                                            Comments

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

                                                                                                                                                                                                                                            Control0..*
                                                                                                                                                                                                                                            This element is affected by the following invariants: cmp-2
                                                                                                                                                                                                                                            TypeReference(Observation Results: IDR)
                                                                                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                                                                                            Summaryfalse
                                                                                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                            376. Composition.section:findings.entry:keyimage
                                                                                                                                                                                                                                            Slice Namekeyimage
                                                                                                                                                                                                                                            Definition

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

                                                                                                                                                                                                                                            ShortA reference to data that supports this section
                                                                                                                                                                                                                                            Comments

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

                                                                                                                                                                                                                                            Control0..*
                                                                                                                                                                                                                                            This element is affected by the following invariants: cmp-2
                                                                                                                                                                                                                                            TypeReference(Imaging Key Image Document Reference)
                                                                                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                                                                                            Summaryfalse
                                                                                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                            378. Composition.section:findings.emptyReason
                                                                                                                                                                                                                                            Definition

                                                                                                                                                                                                                                            If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                                                                                                                                                            ShortWhy the section is empty
                                                                                                                                                                                                                                            Comments

                                                                                                                                                                                                                                            The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                                                                                                                                                            Control0..1
                                                                                                                                                                                                                                            This element is affected by the following invariants: cmp-2
                                                                                                                                                                                                                                            BindingThe codes SHOULD be taken from Reasons a section in an imaging report is empty.
                                                                                                                                                                                                                                            (preferred to http://fhir.ehdsi.eu/imaging/ValueSet/SectionEmptyReason)
                                                                                                                                                                                                                                            TypeCodeableConcept
                                                                                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                                                                                            Summaryfalse
                                                                                                                                                                                                                                            Requirements

                                                                                                                                                                                                                                            Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                            380. Composition.section:findings.section
                                                                                                                                                                                                                                            Definition

                                                                                                                                                                                                                                            A nested sub-section within this section.

                                                                                                                                                                                                                                            ShortNested Section
                                                                                                                                                                                                                                            Comments

                                                                                                                                                                                                                                            Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                                                                                                                                                            Control0..*
                                                                                                                                                                                                                                            This element is affected by the following invariants: cmp-1
                                                                                                                                                                                                                                            TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                                                                                            Summaryfalse
                                                                                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                            382. Composition.section:impression
                                                                                                                                                                                                                                            Slice Nameimpression
                                                                                                                                                                                                                                            Definition

                                                                                                                                                                                                                                            The root of the sections that make up the composition.

                                                                                                                                                                                                                                            ShortImpressions
                                                                                                                                                                                                                                            Control0..1
                                                                                                                                                                                                                                            TypeBackboneElement
                                                                                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                                                                                            Summaryfalse
                                                                                                                                                                                                                                            Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                                                                                                                                                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                                                                                                                                                            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                            384. Composition.section:impression.id
                                                                                                                                                                                                                                            Definition

                                                                                                                                                                                                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                                                                                                            ShortUnique id for inter-element referencing
                                                                                                                                                                                                                                            Control0..1
                                                                                                                                                                                                                                            Typestring
                                                                                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                                                                                                            Summaryfalse
                                                                                                                                                                                                                                            386. Composition.section:impression.extension
                                                                                                                                                                                                                                            Definition

                                                                                                                                                                                                                                            An Extension

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

                                                                                                                                                                                                                                              Additional notes that apply to this resource or element.

                                                                                                                                                                                                                                              ShortAdditional notes that apply to this resource or element.
                                                                                                                                                                                                                                              Comments

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

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

                                                                                                                                                                                                                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                                                                                                                                                                                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                              Comments

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

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

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

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

                                                                                                                                                                                                                                              The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                                                                                                                                                              ShortLabel for section (e.g. for ToC)
                                                                                                                                                                                                                                              Comments

                                                                                                                                                                                                                                              The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                                                                                                                                                              Control0..1
                                                                                                                                                                                                                                              Typestring
                                                                                                                                                                                                                                              Is Modifierfalse
                                                                                                                                                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                                                                                              Obligations
                                                                                                                                                                                                                                                ObligationsActor
                                                                                                                                                                                                                                                SHALL:handleImaging Handler
                                                                                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                                                                                Requirements

                                                                                                                                                                                                                                                Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                                                                                                                                                                Alternate Namesheader, label, caption
                                                                                                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                394. Composition.section:impression.code
                                                                                                                                                                                                                                                Definition

                                                                                                                                                                                                                                                A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                                                                                                                                                                ShortClassification of section (recommended)
                                                                                                                                                                                                                                                Comments

                                                                                                                                                                                                                                                The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                                                                                                                                                                If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                                                                                                                                                                Control1..1
                                                                                                                                                                                                                                                BindingFor example codes, see DocumentSectionCodes
                                                                                                                                                                                                                                                (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                                                                                                                                                                                Classification of a section of a composition/document.

                                                                                                                                                                                                                                                TypeCodeableConcept
                                                                                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                                                                                Requirements

                                                                                                                                                                                                                                                Provides computable standardized labels to topics within the document.

                                                                                                                                                                                                                                                Pattern Value{
                                                                                                                                                                                                                                                  "coding" : [{
                                                                                                                                                                                                                                                    "system" : "http://loinc.org",
                                                                                                                                                                                                                                                    "code" : "19005-8",
                                                                                                                                                                                                                                                    "display" : "Radiology Imaging study [Impression] (narrative)"
                                                                                                                                                                                                                                                  }]
                                                                                                                                                                                                                                                }
                                                                                                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                396. Composition.section:impression.author
                                                                                                                                                                                                                                                Definition

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

                                                                                                                                                                                                                                                ShortWho and/or what authored the section
                                                                                                                                                                                                                                                Control0..*
                                                                                                                                                                                                                                                TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                                                                                Requirements

                                                                                                                                                                                                                                                Identifies who is responsible for the content.

                                                                                                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                398. Composition.section:impression.focus
                                                                                                                                                                                                                                                Definition

                                                                                                                                                                                                                                                The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                                                                                                                                                                ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                                                                                                                                                                Comments

                                                                                                                                                                                                                                                Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                                                                                                                                                                                Control0..1
                                                                                                                                                                                                                                                TypeReference(Resource)
                                                                                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                400. Composition.section:impression.text
                                                                                                                                                                                                                                                Definition

                                                                                                                                                                                                                                                A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

                                                                                                                                                                                                                                                ShortText summary of the section, for human interpretation
                                                                                                                                                                                                                                                Comments

                                                                                                                                                                                                                                                Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                                                                                                                                                                Control0..1
                                                                                                                                                                                                                                                This element is affected by the following invariants: cmp-1
                                                                                                                                                                                                                                                TypeNarrative
                                                                                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                                                                                Obligations
                                                                                                                                                                                                                                                  ObligationsActor
                                                                                                                                                                                                                                                  SHALL:handleImaging Handler
                                                                                                                                                                                                                                                  Summaryfalse
                                                                                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                  402. Composition.section:impression.mode
                                                                                                                                                                                                                                                  Definition

                                                                                                                                                                                                                                                  How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                                                                                                                                                                  Shortworking | snapshot | changes
                                                                                                                                                                                                                                                  Comments

                                                                                                                                                                                                                                                  This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                                                                                                                                                                  Control0..1
                                                                                                                                                                                                                                                  BindingThe codes SHALL be taken from ListMode
                                                                                                                                                                                                                                                  (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                                                                                                                                                                  The processing mode that applies to this section.

                                                                                                                                                                                                                                                  Typecode
                                                                                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                                                                                                  Summaryfalse
                                                                                                                                                                                                                                                  Requirements

                                                                                                                                                                                                                                                  Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                  404. Composition.section:impression.orderedBy
                                                                                                                                                                                                                                                  Definition

                                                                                                                                                                                                                                                  Specifies the order applied to the items in the section entries.

                                                                                                                                                                                                                                                  ShortOrder of section entries
                                                                                                                                                                                                                                                  Comments

                                                                                                                                                                                                                                                  Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                                                                                                                                                                  Control0..1
                                                                                                                                                                                                                                                  BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                                                                                                                                                                  (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                                                                                                                                                                                  What order applies to the items in the entry.

                                                                                                                                                                                                                                                  TypeCodeableConcept
                                                                                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                                                                                  Summaryfalse
                                                                                                                                                                                                                                                  Requirements

                                                                                                                                                                                                                                                  Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                  406. Composition.section:impression.entry
                                                                                                                                                                                                                                                  Definition

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

                                                                                                                                                                                                                                                  ShortA reference to data that supports this section
                                                                                                                                                                                                                                                  Comments

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

                                                                                                                                                                                                                                                  Control0..*
                                                                                                                                                                                                                                                  This element is affected by the following invariants: cmp-2
                                                                                                                                                                                                                                                  TypeReference(Resource)
                                                                                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                                                                                  Summaryfalse
                                                                                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                  SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                                                                                                  • profile @ $this
                                                                                                                                                                                                                                                  • 408. Composition.section:impression.entry:finding
                                                                                                                                                                                                                                                    Slice Namefinding
                                                                                                                                                                                                                                                    Definition

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

                                                                                                                                                                                                                                                    ShortA reference to data that supports this section
                                                                                                                                                                                                                                                    Comments

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

                                                                                                                                                                                                                                                    Control0..*
                                                                                                                                                                                                                                                    This element is affected by the following invariants: cmp-2
                                                                                                                                                                                                                                                    TypeReference(Observation Results: IDR)
                                                                                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                                                                                    Summaryfalse
                                                                                                                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                    410. Composition.section:impression.entry:impression
                                                                                                                                                                                                                                                    Slice Nameimpression
                                                                                                                                                                                                                                                    Definition

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

                                                                                                                                                                                                                                                    ShortA reference to data that supports this section
                                                                                                                                                                                                                                                    Comments

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

                                                                                                                                                                                                                                                    Control0..*
                                                                                                                                                                                                                                                    This element is affected by the following invariants: cmp-2
                                                                                                                                                                                                                                                    TypeReference(Condition)
                                                                                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                                                                                    Summaryfalse
                                                                                                                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                    412. Composition.section:impression.entry:keyimage
                                                                                                                                                                                                                                                    Slice Namekeyimage
                                                                                                                                                                                                                                                    Definition

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

                                                                                                                                                                                                                                                    ShortA reference to data that supports this section
                                                                                                                                                                                                                                                    Comments

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

                                                                                                                                                                                                                                                    Control0..*
                                                                                                                                                                                                                                                    This element is affected by the following invariants: cmp-2
                                                                                                                                                                                                                                                    TypeReference(Imaging Key Image Document Reference)
                                                                                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                                                                                    Summaryfalse
                                                                                                                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                    414. Composition.section:impression.emptyReason
                                                                                                                                                                                                                                                    Definition

                                                                                                                                                                                                                                                    If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                                                                                                                                                                    ShortWhy the section is empty
                                                                                                                                                                                                                                                    Comments

                                                                                                                                                                                                                                                    The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                                                                                                                                                                    Control0..1
                                                                                                                                                                                                                                                    This element is affected by the following invariants: cmp-2
                                                                                                                                                                                                                                                    BindingThe codes SHOULD be taken from Reasons a section in an imaging report is empty.
                                                                                                                                                                                                                                                    (preferred to http://fhir.ehdsi.eu/imaging/ValueSet/SectionEmptyReason)
                                                                                                                                                                                                                                                    TypeCodeableConcept
                                                                                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                                                                                    Summaryfalse
                                                                                                                                                                                                                                                    Requirements

                                                                                                                                                                                                                                                    Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                    416. Composition.section:impression.section
                                                                                                                                                                                                                                                    Definition

                                                                                                                                                                                                                                                    A nested sub-section within this section.

                                                                                                                                                                                                                                                    ShortNested Section
                                                                                                                                                                                                                                                    Comments

                                                                                                                                                                                                                                                    Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                                                                                                                                                                    Control0..*
                                                                                                                                                                                                                                                    This element is affected by the following invariants: cmp-1
                                                                                                                                                                                                                                                    TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                                                                                    Summaryfalse
                                                                                                                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                    418. Composition.section:recommendation
                                                                                                                                                                                                                                                    Slice Namerecommendation
                                                                                                                                                                                                                                                    Definition

                                                                                                                                                                                                                                                    The root of the sections that make up the composition.

                                                                                                                                                                                                                                                    ShortRecommendations
                                                                                                                                                                                                                                                    Control1..1
                                                                                                                                                                                                                                                    TypeBackboneElement
                                                                                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                                                                                    Summaryfalse
                                                                                                                                                                                                                                                    Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                                                                                                                                                                    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                                                                                                                                                                    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                    420. Composition.section:recommendation.id
                                                                                                                                                                                                                                                    Definition

                                                                                                                                                                                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                                                                                                                    ShortUnique id for inter-element referencing
                                                                                                                                                                                                                                                    Control0..1
                                                                                                                                                                                                                                                    Typestring
                                                                                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                                                                                                                    Summaryfalse
                                                                                                                                                                                                                                                    422. Composition.section:recommendation.extension
                                                                                                                                                                                                                                                    Definition

                                                                                                                                                                                                                                                    An Extension

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

                                                                                                                                                                                                                                                      Additional notes that apply to this resource or element.

                                                                                                                                                                                                                                                      ShortAdditional notes that apply to this resource or element.
                                                                                                                                                                                                                                                      Comments

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

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

                                                                                                                                                                                                                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                                                                                                                                                                                                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                      Comments

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

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

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

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

                                                                                                                                                                                                                                                      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                                                                                                                                                                      ShortLabel for section (e.g. for ToC)
                                                                                                                                                                                                                                                      Comments

                                                                                                                                                                                                                                                      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                                                                                                                                                                      Control0..1
                                                                                                                                                                                                                                                      Typestring
                                                                                                                                                                                                                                                      Is Modifierfalse
                                                                                                                                                                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                                                                                                      Obligations
                                                                                                                                                                                                                                                        ObligationsActor
                                                                                                                                                                                                                                                        SHALL:handleImaging Handler
                                                                                                                                                                                                                                                        Summaryfalse
                                                                                                                                                                                                                                                        Requirements

                                                                                                                                                                                                                                                        Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                                                                                                                                                                        Alternate Namesheader, label, caption
                                                                                                                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                        430. Composition.section:recommendation.code
                                                                                                                                                                                                                                                        Definition

                                                                                                                                                                                                                                                        A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                                                                                                                                                                        ShortClassification of section (recommended)
                                                                                                                                                                                                                                                        Comments

                                                                                                                                                                                                                                                        The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                                                                                                                                                                        If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                                                                                                                                                                        Control1..1
                                                                                                                                                                                                                                                        BindingFor example codes, see DocumentSectionCodes
                                                                                                                                                                                                                                                        (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                                                                                                                                                                                        Classification of a section of a composition/document.

                                                                                                                                                                                                                                                        TypeCodeableConcept
                                                                                                                                                                                                                                                        Is Modifierfalse
                                                                                                                                                                                                                                                        Summaryfalse
                                                                                                                                                                                                                                                        Requirements

                                                                                                                                                                                                                                                        Provides computable standardized labels to topics within the document.

                                                                                                                                                                                                                                                        Pattern Value{
                                                                                                                                                                                                                                                          "coding" : [{
                                                                                                                                                                                                                                                            "system" : "http://loinc.org",
                                                                                                                                                                                                                                                            "code" : "18783-1",
                                                                                                                                                                                                                                                            "display" : "Radiology Study recommendation (narrative)"
                                                                                                                                                                                                                                                          }]
                                                                                                                                                                                                                                                        }
                                                                                                                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                        432. Composition.section:recommendation.author
                                                                                                                                                                                                                                                        Definition

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

                                                                                                                                                                                                                                                        ShortWho and/or what authored the section
                                                                                                                                                                                                                                                        Control0..*
                                                                                                                                                                                                                                                        TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                                                                                                                                                                        Is Modifierfalse
                                                                                                                                                                                                                                                        Summaryfalse
                                                                                                                                                                                                                                                        Requirements

                                                                                                                                                                                                                                                        Identifies who is responsible for the content.

                                                                                                                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                        434. Composition.section:recommendation.focus
                                                                                                                                                                                                                                                        Definition

                                                                                                                                                                                                                                                        The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                                                                                                                                                                        ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                                                                                                                                                                        Comments

                                                                                                                                                                                                                                                        Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                                                                                                                                                                                        Control0..1
                                                                                                                                                                                                                                                        TypeReference(Resource)
                                                                                                                                                                                                                                                        Is Modifierfalse
                                                                                                                                                                                                                                                        Summaryfalse
                                                                                                                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                        436. Composition.section:recommendation.text
                                                                                                                                                                                                                                                        Definition

                                                                                                                                                                                                                                                        A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

                                                                                                                                                                                                                                                        ShortText summary of the section, for human interpretation
                                                                                                                                                                                                                                                        Comments

                                                                                                                                                                                                                                                        Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                                                                                                                                                                        Control0..1
                                                                                                                                                                                                                                                        This element is affected by the following invariants: cmp-1
                                                                                                                                                                                                                                                        TypeNarrative
                                                                                                                                                                                                                                                        Is Modifierfalse
                                                                                                                                                                                                                                                        Obligations
                                                                                                                                                                                                                                                          ObligationsActor
                                                                                                                                                                                                                                                          SHALL:handleImaging Handler
                                                                                                                                                                                                                                                          Summaryfalse
                                                                                                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                          438. Composition.section:recommendation.mode
                                                                                                                                                                                                                                                          Definition

                                                                                                                                                                                                                                                          How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                                                                                                                                                                          Shortworking | snapshot | changes
                                                                                                                                                                                                                                                          Comments

                                                                                                                                                                                                                                                          This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                                                                                                                                                                          Control0..1
                                                                                                                                                                                                                                                          BindingThe codes SHALL be taken from ListMode
                                                                                                                                                                                                                                                          (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                                                                                                                                                                          The processing mode that applies to this section.

                                                                                                                                                                                                                                                          Typecode
                                                                                                                                                                                                                                                          Is Modifierfalse
                                                                                                                                                                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                                                                                                          Summaryfalse
                                                                                                                                                                                                                                                          Requirements

                                                                                                                                                                                                                                                          Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                          440. Composition.section:recommendation.orderedBy
                                                                                                                                                                                                                                                          Definition

                                                                                                                                                                                                                                                          Specifies the order applied to the items in the section entries.

                                                                                                                                                                                                                                                          ShortOrder of section entries
                                                                                                                                                                                                                                                          Comments

                                                                                                                                                                                                                                                          Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                                                                                                                                                                          Control0..1
                                                                                                                                                                                                                                                          BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                                                                                                                                                                          (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                                                                                                                                                                                          What order applies to the items in the entry.

                                                                                                                                                                                                                                                          TypeCodeableConcept
                                                                                                                                                                                                                                                          Is Modifierfalse
                                                                                                                                                                                                                                                          Summaryfalse
                                                                                                                                                                                                                                                          Requirements

                                                                                                                                                                                                                                                          Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                          442. Composition.section:recommendation.entry
                                                                                                                                                                                                                                                          Definition

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

                                                                                                                                                                                                                                                          ShortA reference to data that supports this section
                                                                                                                                                                                                                                                          Comments

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

                                                                                                                                                                                                                                                          Control0..*
                                                                                                                                                                                                                                                          This element is affected by the following invariants: cmp-2
                                                                                                                                                                                                                                                          TypeReference(Resource)
                                                                                                                                                                                                                                                          Is Modifierfalse
                                                                                                                                                                                                                                                          Summaryfalse
                                                                                                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                          SlicingThis element introduces a set of slices on Composition.section.entry. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                                                                                                          • profile @ $this
                                                                                                                                                                                                                                                          • 444. Composition.section:recommendation.entry:careplan
                                                                                                                                                                                                                                                            Slice Namecareplan
                                                                                                                                                                                                                                                            Definition

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

                                                                                                                                                                                                                                                            ShortA reference to data that supports this section
                                                                                                                                                                                                                                                            Comments

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

                                                                                                                                                                                                                                                            Control0..*
                                                                                                                                                                                                                                                            This element is affected by the following invariants: cmp-2
                                                                                                                                                                                                                                                            TypeReference(CarePlan)
                                                                                                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                                                                                                            Summaryfalse
                                                                                                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                            446. Composition.section:recommendation.emptyReason
                                                                                                                                                                                                                                                            Definition

                                                                                                                                                                                                                                                            If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                                                                                                                                                                            ShortWhy the section is empty
                                                                                                                                                                                                                                                            Comments

                                                                                                                                                                                                                                                            The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                                                                                                                                                                            Control0..1
                                                                                                                                                                                                                                                            This element is affected by the following invariants: cmp-2
                                                                                                                                                                                                                                                            BindingThe codes SHOULD be taken from Reasons a section in an imaging report is empty.
                                                                                                                                                                                                                                                            (preferred to http://fhir.ehdsi.eu/imaging/ValueSet/SectionEmptyReason)
                                                                                                                                                                                                                                                            TypeCodeableConcept
                                                                                                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                                                                                                            Summaryfalse
                                                                                                                                                                                                                                                            Requirements

                                                                                                                                                                                                                                                            Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                            448. Composition.section:recommendation.section
                                                                                                                                                                                                                                                            Definition

                                                                                                                                                                                                                                                            A nested sub-section within this section.

                                                                                                                                                                                                                                                            ShortNested Section
                                                                                                                                                                                                                                                            Comments

                                                                                                                                                                                                                                                            Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                                                                                                                                                                            Control0..*
                                                                                                                                                                                                                                                            This element is affected by the following invariants: cmp-1
                                                                                                                                                                                                                                                            TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                                                                                                            Summaryfalse
                                                                                                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                            450. Composition.section:communication
                                                                                                                                                                                                                                                            Slice Namecommunication
                                                                                                                                                                                                                                                            Definition

                                                                                                                                                                                                                                                            The root of the sections that make up the composition.

                                                                                                                                                                                                                                                            ShortCommunications
                                                                                                                                                                                                                                                            Control0..1
                                                                                                                                                                                                                                                            TypeBackboneElement
                                                                                                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                                                                                                            Summaryfalse
                                                                                                                                                                                                                                                            Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                                                                                                                                                                                                                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                                                                                                                                                                                                                            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                            452. Composition.section:communication.id
                                                                                                                                                                                                                                                            Definition

                                                                                                                                                                                                                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                                                                                                                            ShortUnique id for inter-element referencing
                                                                                                                                                                                                                                                            Control0..1
                                                                                                                                                                                                                                                            Typestring
                                                                                                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                                                                                                                            Summaryfalse
                                                                                                                                                                                                                                                            454. Composition.section:communication.extension
                                                                                                                                                                                                                                                            Definition

                                                                                                                                                                                                                                                            An Extension

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

                                                                                                                                                                                                                                                              Additional notes that apply to this resource or element.

                                                                                                                                                                                                                                                              ShortAdditional notes that apply to this resource or element.
                                                                                                                                                                                                                                                              Comments

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

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

                                                                                                                                                                                                                                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

                                                                                                                                                                                                                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                                                                                              Comments

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

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

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

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

                                                                                                                                                                                                                                                              The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                                                                                                                                                                                                                              ShortLabel for section (e.g. for ToC)
                                                                                                                                                                                                                                                              Comments

                                                                                                                                                                                                                                                              The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                                                                                                                                                                                                                              Control0..1
                                                                                                                                                                                                                                                              Typestring
                                                                                                                                                                                                                                                              Is Modifierfalse
                                                                                                                                                                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                                                                                                              Obligations
                                                                                                                                                                                                                                                                ObligationsActor
                                                                                                                                                                                                                                                                SHALL:handleImaging Handler
                                                                                                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                                                                                                Requirements

                                                                                                                                                                                                                                                                Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                                                                                                                                                                                                                                Alternate Namesheader, label, caption
                                                                                                                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                                462. Composition.section:communication.code
                                                                                                                                                                                                                                                                Definition

                                                                                                                                                                                                                                                                A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                                                                                                                                                                                                                                ShortClassification of section (recommended)
                                                                                                                                                                                                                                                                Comments

                                                                                                                                                                                                                                                                The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                                                                                                                                                                                                                                If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                                                                                                                                                                                                                                Control1..1
                                                                                                                                                                                                                                                                BindingFor example codes, see DocumentSectionCodes
                                                                                                                                                                                                                                                                (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                                                                                                                                                                                                                                Classification of a section of a composition/document.

                                                                                                                                                                                                                                                                TypeCodeableConcept
                                                                                                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                                                                                                Requirements

                                                                                                                                                                                                                                                                Provides computable standardized labels to topics within the document.

                                                                                                                                                                                                                                                                Pattern Value{
                                                                                                                                                                                                                                                                  "coding" : [{
                                                                                                                                                                                                                                                                    "system" : "http://loinc.org",
                                                                                                                                                                                                                                                                    "code" : "18783-1",
                                                                                                                                                                                                                                                                    "display" : "Radiology Study recommendation (narrative)"
                                                                                                                                                                                                                                                                  }]
                                                                                                                                                                                                                                                                }
                                                                                                                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                                464. Composition.section:communication.author
                                                                                                                                                                                                                                                                Definition

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

                                                                                                                                                                                                                                                                ShortWho and/or what authored the section
                                                                                                                                                                                                                                                                Control0..*
                                                                                                                                                                                                                                                                TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                                                                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                                                                                                Requirements

                                                                                                                                                                                                                                                                Identifies who is responsible for the content.

                                                                                                                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                                466. Composition.section:communication.focus
                                                                                                                                                                                                                                                                Definition

                                                                                                                                                                                                                                                                The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                                                                                                                                                                                                                                ShortWho/what the section is about, when it is not about the subject of composition
                                                                                                                                                                                                                                                                Comments

                                                                                                                                                                                                                                                                Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                                                                                                                                                                                                                                Control0..1
                                                                                                                                                                                                                                                                TypeReference(Resource)
                                                                                                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                                                                                                Summaryfalse
                                                                                                                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                                468. Composition.section:communication.text
                                                                                                                                                                                                                                                                Definition

                                                                                                                                                                                                                                                                A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

                                                                                                                                                                                                                                                                ShortText summary of the section, for human interpretation
                                                                                                                                                                                                                                                                Comments

                                                                                                                                                                                                                                                                Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                                                                                                                                                                                                                                Control0..1
                                                                                                                                                                                                                                                                This element is affected by the following invariants: cmp-1
                                                                                                                                                                                                                                                                TypeNarrative
                                                                                                                                                                                                                                                                Is Modifierfalse
                                                                                                                                                                                                                                                                Obligations
                                                                                                                                                                                                                                                                  ObligationsActor
                                                                                                                                                                                                                                                                  SHALL:handleImaging Handler
                                                                                                                                                                                                                                                                  Summaryfalse
                                                                                                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                                  470. Composition.section:communication.mode
                                                                                                                                                                                                                                                                  Definition

                                                                                                                                                                                                                                                                  How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                                                                                                                                                                                                                                  Shortworking | snapshot | changes
                                                                                                                                                                                                                                                                  Comments

                                                                                                                                                                                                                                                                  This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                                                                                                                                                                                                                                  Control0..1
                                                                                                                                                                                                                                                                  BindingThe codes SHALL be taken from ListMode
                                                                                                                                                                                                                                                                  (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                                                                                                                                                                                                                                  The processing mode that applies to this section.

                                                                                                                                                                                                                                                                  Typecode
                                                                                                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                                                                                                                  Summaryfalse
                                                                                                                                                                                                                                                                  Requirements

                                                                                                                                                                                                                                                                  Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                                                                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                                  472. Composition.section:communication.orderedBy
                                                                                                                                                                                                                                                                  Definition

                                                                                                                                                                                                                                                                  Specifies the order applied to the items in the section entries.

                                                                                                                                                                                                                                                                  ShortOrder of section entries
                                                                                                                                                                                                                                                                  Comments

                                                                                                                                                                                                                                                                  Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                                                                                                                                                                                                                                  Control0..1
                                                                                                                                                                                                                                                                  BindingThe codes SHOULD be taken from ListOrderCodes
                                                                                                                                                                                                                                                                  (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                                                                                                                                                                                                                                  What order applies to the items in the entry.

                                                                                                                                                                                                                                                                  TypeCodeableConcept
                                                                                                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                                                                                                  Summaryfalse
                                                                                                                                                                                                                                                                  Requirements

                                                                                                                                                                                                                                                                  Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                                                                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                                  474. Composition.section:communication.entry
                                                                                                                                                                                                                                                                  Definition

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

                                                                                                                                                                                                                                                                  ShortA reference to data that supports this section
                                                                                                                                                                                                                                                                  Comments

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

                                                                                                                                                                                                                                                                  Control0..*
                                                                                                                                                                                                                                                                  This element is affected by the following invariants: cmp-2
                                                                                                                                                                                                                                                                  TypeReference(Resource)
                                                                                                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                                                                                                  Obligations
                                                                                                                                                                                                                                                                    ObligationsActor
                                                                                                                                                                                                                                                                    SHALL:handleImaging Handler
                                                                                                                                                                                                                                                                    SHALL:handleImaging Handler
                                                                                                                                                                                                                                                                    Summaryfalse
                                                                                                                                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                                    476. Composition.section:communication.emptyReason
                                                                                                                                                                                                                                                                    Definition

                                                                                                                                                                                                                                                                    If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                                                                                                                                                                                                                                    ShortWhy the section is empty
                                                                                                                                                                                                                                                                    Comments

                                                                                                                                                                                                                                                                    The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                                                                                                                                                                                                                                    Control0..1
                                                                                                                                                                                                                                                                    This element is affected by the following invariants: cmp-2
                                                                                                                                                                                                                                                                    BindingThe codes SHOULD be taken from Reasons a section in an imaging report is empty.
                                                                                                                                                                                                                                                                    (preferred to http://fhir.ehdsi.eu/imaging/ValueSet/SectionEmptyReason)
                                                                                                                                                                                                                                                                    TypeCodeableConcept
                                                                                                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                                                                                                    Summaryfalse
                                                                                                                                                                                                                                                                    Requirements

                                                                                                                                                                                                                                                                    Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                                                                                                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                                    478. Composition.section:communication.section
                                                                                                                                                                                                                                                                    Definition

                                                                                                                                                                                                                                                                    A nested sub-section within this section.

                                                                                                                                                                                                                                                                    ShortNested Section
                                                                                                                                                                                                                                                                    Comments

                                                                                                                                                                                                                                                                    Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                                                                                                                                                                                                                                    Control0..*
                                                                                                                                                                                                                                                                    This element is affected by the following invariants: cmp-1
                                                                                                                                                                                                                                                                    TypeSeettp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                                                                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                                                                                                    Summaryfalse
                                                                                                                                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))