My Health Record FHIR IG
1.2.0 - active Australia flag

My Health Record FHIR IG - Local Development build (v1.2.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: MHRCompositionDocumentMCV - Detailed Descriptions

Active as of 2024-09-19

Definitions for the dh-composition-mcv-1 resource profile.

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

0. Composition
Invariantsinv-mcv-comp-01: Contained resources shall have a valid identifier (contained.device.exists() implies contained.device.all($this.identifier.exists()))
2. Composition.id
Control1..?
4. Composition.language
Fixed Valueen-AU
6. Composition.status
Control1..?
Must Supporttrue
Obligations
    ObligationsActor
    SHALL:handleMHR Gateway Requester
    Fixed Valuefinal
    8. Composition.type
    Control1..?
    BindingUnless not suitable, these codes SHALL be taken from My Health Record Record Type .
    (extensible to https://healthterminologies.gov.au/fhir/ValueSet/mhr-record-type-1)
    Must Supporttrue
    Obligations
      ObligationsActor
      SHALL:handleMHR Gateway Requester
      Pattern Value{
        "coding" : [{
          "system" : "https://healthterminologies.gov.au/fhir/CodeSystem/nctis-data-components-1",
          "code" : "100.32051",
          "display" : "Medical Conditions View"
        }]
      }
      10. Composition.category
      Control1..1
      BindingUnless not suitable, these codes SHALL be taken from My Health Record Record Class .
      (extensible to https://healthterminologies.gov.au/fhir/ValueSet/mhr-record-class-1)
      Must Supporttrue
      Obligations
        ObligationsActor
        SHALL:handleMHR Gateway Requester
        Pattern Value{
          "coding" : [{
            "system" : "https://healthterminologies.gov.au/fhir/CodeSystem/nctis-data-components-1",
            "code" : "100.32050",
            "display" : "Patient Health Summary"
          }]
        }
        12. Composition.subject
        Control1..1
        TypeReference(MHR Patient)
        Must Supporttrue
        Obligations
          ObligationsActor
          SHALL:handleMHR Gateway Requester
          14. Composition.date
          Must Supporttrue
          Obligations
            ObligationsActor
            SHALL:handleMHR Gateway Requester
            16. Composition.author
            Control1..1
            TypeReference(Device)
            Must Supporttrue
            Obligations
              ObligationsActor
              SHALL:handleMHR Gateway Requester
              18. Composition.title
              Must Supporttrue
              Obligations
                ObligationsActor
                SHALL:handleMHR Gateway Requester
                Fixed ValueMedical Conditions View
                20. Composition.custodian
                Control1..?
                TypeReference(AU Core Organization)
                Must Supporttrue
                Obligations
                  ObligationsActor
                  SHALL:handleMHR Gateway Requester
                  22. Composition.section
                  Control2..2
                  Must Supporttrue
                  Obligations
                    ObligationsActor
                    SHALL:handleMHR Gateway Requester
                    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
                    • 24. Composition.section:allergiesAdverseReactions
                      Slice NameallergiesAdverseReactions
                      Control1..1
                      Must Supporttrue
                      Obligations
                        ObligationsActor
                        SHALL:handleMHR Gateway Requester
                        26. Composition.section:allergiesAdverseReactions.title
                        Control1..?
                        Must Supporttrue
                        Obligations
                          ObligationsActor
                          SHALL:handleMHR Gateway Requester
                          Fixed ValueAllergies and Adverse Reactions
                          28. Composition.section:allergiesAdverseReactions.code
                          Control1..?
                          Must Supporttrue
                          Obligations
                            ObligationsActor
                            SHALL:handleMHR Gateway Requester
                            Pattern Value{
                              "coding" : [{
                                "system" : "https://healthterminologies.gov.au/fhir/CodeSystem/nctis-data-components-1",
                                "code" : "101.20113",
                                "display" : "Adverse Reactions"
                              }]
                            }
                            30. Composition.section:allergiesAdverseReactions.mode
                            Control1..?
                            Must Supporttrue
                            Obligations
                              ObligationsActor
                              SHALL:handleMHR Gateway Requester
                              Fixed Valuesnapshot
                              32. Composition.section:allergiesAdverseReactions.entry
                              TypeReference(MHR Medical Conditions View AllergyIntolerance)
                              Must Supporttrue
                              Obligations
                                ObligationsActor
                                SHALL:handleMHR Gateway Requester
                                34. Composition.section:infoMedicalConditions
                                Slice NameinfoMedicalConditions
                                Control1..1
                                Must Supporttrue
                                Obligations
                                  ObligationsActor
                                  SHALL:handleMHR Gateway Requester
                                  36. Composition.section:infoMedicalConditions.title
                                  Control1..?
                                  Must Supporttrue
                                  Obligations
                                    ObligationsActor
                                    SHALL:handleMHR Gateway Requester
                                    Fixed ValueInformation on medical conditions, treatments and other history
                                    38. Composition.section:infoMedicalConditions.code
                                    Control1..?
                                    Must Supporttrue
                                    Obligations
                                      ObligationsActor
                                      SHALL:handleMHR Gateway Requester
                                      Pattern Value{
                                        "coding" : [{
                                          "system" : "https://healthterminologies.gov.au/fhir/CodeSystem/nctis-data-components-1",
                                          "code" : "101.16117",
                                          "display" : "Medical History"
                                        }]
                                      }
                                      40. Composition.section:infoMedicalConditions.mode
                                      Control1..?
                                      Must Supporttrue
                                      Obligations
                                        ObligationsActor
                                        SHALL:handleMHR Gateway Requester
                                        Fixed Valuesnapshot
                                        42. Composition.section:infoMedicalConditions.entry
                                        TypeReference(MHR Medical Conditions View Condition, MHR Medical Conditions View Explanation of Benefit, MHR Medical Conditions View Flag, MHR Medical Conditions View Observation, MHR Medical Conditions View Procedure)
                                        Must Supporttrue
                                        Must Support TypesNo must-support rules about the choice of types/profiles
                                        Obligations
                                          ObligationsActor
                                          SHALL:handleMHR Gateway Requester

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

                                          0. Composition
                                          Definition

                                          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.).

                                          ShortComposition for the Australian realmA 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..*
                                          This element is affected by the following invariants: inv-mcv-comp-01
                                          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())
                                          inv-mcv-comp-01: Contained resources shall have a valid identifier (contained.device.exists() implies contained.device.all($this.identifier.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.

                                          Control10..1
                                          Typeidstring
                                          Is Modifierfalse
                                          Summarytrue
                                          4. 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()))
                                          6. 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).

                                          Control0..1
                                          BindingThe codes SHOULD be taken from CommonLanguageshttp://hl7.org/fhir/ValueSet/languages
                                          (preferred to http://hl7.org/fhir/ValueSet/languages)

                                          A human language.

                                          Additional BindingsPurpose
                                          AllLanguagesMax Binding
                                          Typecode
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summaryfalse
                                          Fixed Valueen-AU
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          8. Composition.extension:informationRecipient
                                          Slice NameinformationRecipient
                                          Definition

                                          A recipient who should receive a copy of the composition. A recipient is an entity to whom a copy of the composition is directed at the time of authoring of the composition.

                                          ShortWho and/or what should receive a copy of the composition
                                          Control0..*
                                          This element is affected by the following invariants: ele-1
                                          TypeExtension(Information Recipient) (Extension Type: Reference(Practitioner, Device, Patient, RelatedPerson, PractitionerRole, Organization))
                                          Is Modifierfalse
                                          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.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())
                                          12. 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
                                          Must Supporttrue
                                          Obligations
                                            ObligationsActor
                                            SHALL:handleMHR Gateway Requester
                                            Summarytrue
                                            Requirements

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

                                            Fixed Valuefinal
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            14. 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
                                            BindingUnless not suitable, these codes SHALL be taken from The codes SHOULD be taken from My Health Record Record Type .http://hl7.org/fhir/ValueSet/doc-typecodes
                                            (extensible to https://healthterminologies.gov.au/fhir/ValueSet/mhr-record-type-1)
                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Must Supporttrue
                                            Obligations
                                              ObligationsActor
                                              SHALL:handleMHR Gateway Requester
                                              Summarytrue
                                              Requirements

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

                                              Pattern Value{
                                                "coding" : [{
                                                  "system" : "https://healthterminologies.gov.au/fhir/CodeSystem/nctis-data-components-1",
                                                  "code" : "100.32051",
                                                  "display" : "Medical Conditions View"
                                                }]
                                              }
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              16. 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.

                                              Control10..1*
                                              BindingUnless not suitable, these codes SHALL be taken from For example codes, see My Health Record Record Class .http://hl7.org/fhir/ValueSet/document-classcodes
                                              (extensible to https://healthterminologies.gov.au/fhir/ValueSet/mhr-record-class-1)
                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Obligations
                                                ObligationsActor
                                                SHALL:handleMHR Gateway Requester
                                                Summarytrue
                                                Requirements

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

                                                Pattern Value{
                                                  "coding" : [{
                                                    "system" : "https://healthterminologies.gov.au/fhir/CodeSystem/nctis-data-components-1",
                                                    "code" : "100.32050",
                                                    "display" : "Patient Health Summary"
                                                  }]
                                                }
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                18. Composition.subject
                                                Definition

                                                Who or what the composition is about. 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(MHR Patient, Resource)
                                                Is Modifierfalse
                                                Must Supporttrue
                                                Obligations
                                                  ObligationsActor
                                                  SHALL:handleMHR Gateway Requester
                                                  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()))
                                                  20. 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
                                                  Must Supporttrue
                                                  Obligations
                                                    ObligationsActor
                                                    SHALL:handleMHR Gateway Requester
                                                    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()))
                                                    22. 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..1*
                                                    TypeReference(Device, Practitioner, PractitionerRole, Patient, RelatedPerson, Organization)
                                                    Is Modifierfalse
                                                    Must Supporttrue
                                                    Obligations
                                                      ObligationsActor
                                                      SHALL:handleMHR Gateway Requester
                                                      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()))
                                                      24. 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
                                                      Must Supporttrue
                                                      Obligations
                                                        ObligationsActor
                                                        SHALL:handleMHR Gateway Requester
                                                        Summarytrue
                                                        Fixed ValueMedical Conditions View
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        26. Composition.custodian
                                                        Definition

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

                                                        ShortOrganization 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.

                                                        Control10..1
                                                        TypeReference(AU Core Organization, Organization)
                                                        Is Modifierfalse
                                                        Must Supporttrue
                                                        Obligations
                                                          ObligationsActor
                                                          SHALL:handleMHR Gateway Requester
                                                          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()))
                                                          28. Composition.section
                                                          Definition

                                                          The root of the sections that make up the composition.

                                                          ShortComposition is broken into sections
                                                          Control20..2*
                                                          TypeBackboneElement
                                                          Is Modifierfalse
                                                          Must Supporttrue
                                                          Obligations
                                                            ObligationsActor
                                                            SHALL:handleMHR Gateway Requester
                                                            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())
                                                            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
                                                            • 30. 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())
                                                              32. Composition.section:allergiesAdverseReactions
                                                              Slice NameallergiesAdverseReactions
                                                              Definition

                                                              The root of the sections that make up the composition.

                                                              ShortComposition is broken into sections
                                                              Control10..1*
                                                              TypeBackboneElement
                                                              Is Modifierfalse
                                                              Must Supporttrue
                                                              Obligations
                                                                ObligationsActor
                                                                SHALL:handleMHR Gateway Requester
                                                                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())
                                                                34. Composition.section:allergiesAdverseReactions.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())
                                                                36. Composition.section:allergiesAdverseReactions.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.

                                                                Control10..1
                                                                Typestring
                                                                Is Modifierfalse
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Must Supporttrue
                                                                Obligations
                                                                  ObligationsActor
                                                                  SHALL:handleMHR Gateway Requester
                                                                  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
                                                                  Fixed ValueAllergies and Adverse Reactions
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  38. Composition.section:allergiesAdverseReactions.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
                                                                  Must Supporttrue
                                                                  Obligations
                                                                    ObligationsActor
                                                                    SHALL:handleMHR Gateway Requester
                                                                    Summaryfalse
                                                                    Requirements

                                                                    Provides computable standardized labels to topics within the document.

                                                                    Pattern Value{
                                                                      "coding" : [{
                                                                        "system" : "https://healthterminologies.gov.au/fhir/CodeSystem/nctis-data-components-1",
                                                                        "code" : "101.20113",
                                                                        "display" : "Adverse Reactions"
                                                                      }]
                                                                    }
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    40. Composition.section:allergiesAdverseReactions.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.

                                                                    Control10..1
                                                                    BindingThe codes SHALL be taken from ListModehttp://hl7.org/fhir/ValueSet/list-mode|4.0.1
                                                                    (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
                                                                    Must Supporttrue
                                                                    Obligations
                                                                      ObligationsActor
                                                                      SHALL:handleMHR Gateway Requester
                                                                      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.

                                                                      Fixed Valuesnapshot
                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      42. Composition.section:allergiesAdverseReactions.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(MHR Medical Conditions View AllergyIntolerance, Resource)
                                                                      Is Modifierfalse
                                                                      Must Supporttrue
                                                                      Obligations
                                                                        ObligationsActor
                                                                        SHALL:handleMHR Gateway Requester
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        44. Composition.section:infoMedicalConditions
                                                                        Slice NameinfoMedicalConditions
                                                                        Definition

                                                                        The root of the sections that make up the composition.

                                                                        ShortComposition is broken into sections
                                                                        Control10..1*
                                                                        TypeBackboneElement
                                                                        Is Modifierfalse
                                                                        Must Supporttrue
                                                                        Obligations
                                                                          ObligationsActor
                                                                          SHALL:handleMHR Gateway Requester
                                                                          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())
                                                                          46. Composition.section:infoMedicalConditions.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())
                                                                          48. Composition.section:infoMedicalConditions.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.

                                                                          Control10..1
                                                                          Typestring
                                                                          Is Modifierfalse
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Must Supporttrue
                                                                          Obligations
                                                                            ObligationsActor
                                                                            SHALL:handleMHR Gateway Requester
                                                                            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
                                                                            Fixed ValueInformation on medical conditions, treatments and other history
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            50. Composition.section:infoMedicalConditions.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
                                                                            Must Supporttrue
                                                                            Obligations
                                                                              ObligationsActor
                                                                              SHALL:handleMHR Gateway Requester
                                                                              Summaryfalse
                                                                              Requirements

                                                                              Provides computable standardized labels to topics within the document.

                                                                              Pattern Value{
                                                                                "coding" : [{
                                                                                  "system" : "https://healthterminologies.gov.au/fhir/CodeSystem/nctis-data-components-1",
                                                                                  "code" : "101.16117",
                                                                                  "display" : "Medical History"
                                                                                }]
                                                                              }
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              52. Composition.section:infoMedicalConditions.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.

                                                                              Control10..1
                                                                              BindingThe codes SHALL be taken from ListModehttp://hl7.org/fhir/ValueSet/list-mode|4.0.1
                                                                              (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
                                                                              Must Supporttrue
                                                                              Obligations
                                                                                ObligationsActor
                                                                                SHALL:handleMHR Gateway Requester
                                                                                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.

                                                                                Fixed Valuesnapshot
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                54. Composition.section:infoMedicalConditions.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(MHR Medical Conditions View Condition, MHR Medical Conditions View Explanation of Benefit, MHR Medical Conditions View Flag, MHR Medical Conditions View Observation, MHR Medical Conditions View Procedure, Resource)
                                                                                Is Modifierfalse
                                                                                Must Supporttrue
                                                                                Must Support TypesNo must-support rules about the choice of types/profiles
                                                                                Obligations
                                                                                  ObligationsActor
                                                                                  SHALL:handleMHR Gateway Requester
                                                                                  Summaryfalse
                                                                                  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 found here

                                                                                  0. Composition
                                                                                  Definition

                                                                                  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.).

                                                                                  ShortComposition for the Australian realm
                                                                                  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..*
                                                                                  This element is affected by the following invariants: inv-mcv-comp-01
                                                                                  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())
                                                                                  inv-mcv-comp-01: Contained resources shall have a valid identifier (contained.device.exists() implies contained.device.all($this.identifier.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.

                                                                                  Control1..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).

                                                                                  Control0..1
                                                                                  BindingThe codes SHOULD be taken from CommonLanguages
                                                                                  (preferred to http://hl7.org/fhir/ValueSet/languages)

                                                                                  A human language.

                                                                                  Additional BindingsPurpose
                                                                                  AllLanguagesMax Binding
                                                                                  Typecode
                                                                                  Is Modifierfalse
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Summaryfalse
                                                                                  Fixed Valueen-AU
                                                                                  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:informationRecipient
                                                                                    Slice NameinformationRecipient
                                                                                    Definition

                                                                                    A recipient who should receive a copy of the composition. A recipient is an entity to whom a copy of the composition is directed at the time of authoring of the composition.

                                                                                    ShortWho and/or what should receive a copy of the composition
                                                                                    Control0..*
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    TypeExtension(Information Recipient) (Extension Type: Reference(Practitioner, Device, Patient, RelatedPerson, PractitionerRole, Organization))
                                                                                    Is Modifierfalse
                                                                                    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.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())
                                                                                    20. 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)
                                                                                    Control0..1
                                                                                    TypeIdentifier
                                                                                    Is Modifierfalse
                                                                                    Summarytrue
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    22. 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
                                                                                    Must Supporttrue
                                                                                    Obligations
                                                                                      ObligationsActor
                                                                                      SHALL:handleMHR Gateway Requester
                                                                                      Summarytrue
                                                                                      Requirements

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

                                                                                      Fixed Valuefinal
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      24. 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
                                                                                      BindingUnless not suitable, these codes SHALL be taken from My Health Record Record Type .
                                                                                      (extensible to https://healthterminologies.gov.au/fhir/ValueSet/mhr-record-type-1)
                                                                                      TypeCodeableConcept
                                                                                      Is Modifierfalse
                                                                                      Must Supporttrue
                                                                                      Obligations
                                                                                        ObligationsActor
                                                                                        SHALL:handleMHR Gateway Requester
                                                                                        Summarytrue
                                                                                        Requirements

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

                                                                                        Pattern Value{
                                                                                          "coding" : [{
                                                                                            "system" : "https://healthterminologies.gov.au/fhir/CodeSystem/nctis-data-components-1",
                                                                                            "code" : "100.32051",
                                                                                            "display" : "Medical Conditions View"
                                                                                          }]
                                                                                        }
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        26. 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.

                                                                                        Control1..1
                                                                                        BindingUnless not suitable, these codes SHALL be taken from My Health Record Record Class .
                                                                                        (extensible to https://healthterminologies.gov.au/fhir/ValueSet/mhr-record-class-1)
                                                                                        TypeCodeableConcept
                                                                                        Is Modifierfalse
                                                                                        Must Supporttrue
                                                                                        Obligations
                                                                                          ObligationsActor
                                                                                          SHALL:handleMHR Gateway Requester
                                                                                          Summarytrue
                                                                                          Requirements

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

                                                                                          Pattern Value{
                                                                                            "coding" : [{
                                                                                              "system" : "https://healthterminologies.gov.au/fhir/CodeSystem/nctis-data-components-1",
                                                                                              "code" : "100.32050",
                                                                                              "display" : "Patient Health Summary"
                                                                                            }]
                                                                                          }
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          28. 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(MHR Patient)
                                                                                          Is Modifierfalse
                                                                                          Must Supporttrue
                                                                                          Obligations
                                                                                            ObligationsActor
                                                                                            SHALL:handleMHR Gateway Requester
                                                                                            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()))
                                                                                            30. 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()))
                                                                                            32. 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
                                                                                            Must Supporttrue
                                                                                            Obligations
                                                                                              ObligationsActor
                                                                                              SHALL:handleMHR Gateway Requester
                                                                                              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()))
                                                                                              34. 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..1
                                                                                              TypeReference(Device)
                                                                                              Is Modifierfalse
                                                                                              Must Supporttrue
                                                                                              Obligations
                                                                                                ObligationsActor
                                                                                                SHALL:handleMHR Gateway Requester
                                                                                                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()))
                                                                                                36. 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
                                                                                                Must Supporttrue
                                                                                                Obligations
                                                                                                  ObligationsActor
                                                                                                  SHALL:handleMHR Gateway Requester
                                                                                                  Summarytrue
                                                                                                  Fixed ValueMedical Conditions View
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  38. 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()))
                                                                                                  40. 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()))
                                                                                                  42. 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
                                                                                                  44. 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())
                                                                                                  46. 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())
                                                                                                  48. 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()))
                                                                                                  50. 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
                                                                                                  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()))
                                                                                                  52. 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
                                                                                                  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()))
                                                                                                  54. Composition.custodian
                                                                                                  Definition

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

                                                                                                  ShortOrganization 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.

                                                                                                  Control1..1
                                                                                                  TypeReference(AU Core Organization)
                                                                                                  Is Modifierfalse
                                                                                                  Must Supporttrue
                                                                                                  Obligations
                                                                                                    ObligationsActor
                                                                                                    SHALL:handleMHR Gateway Requester
                                                                                                    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()))
                                                                                                    56. 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()))
                                                                                                    58. 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
                                                                                                    60. 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())
                                                                                                    62. 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())
                                                                                                    64. 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()))
                                                                                                    66. 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()))
                                                                                                    68. 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.

                                                                                                    Control0..*
                                                                                                    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()))
                                                                                                    70. 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
                                                                                                    72. 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())
                                                                                                    74. 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())
                                                                                                    76. 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()))
                                                                                                    78. 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()))
                                                                                                    80. 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()))
                                                                                                    82. Composition.section
                                                                                                    Definition

                                                                                                    The root of the sections that make up the composition.

                                                                                                    ShortComposition is broken into sections
                                                                                                    Control2..2
                                                                                                    TypeBackboneElement
                                                                                                    Is Modifierfalse
                                                                                                    Must Supporttrue
                                                                                                    Obligations
                                                                                                      ObligationsActor
                                                                                                      SHALL:handleMHR Gateway Requester
                                                                                                      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()))
                                                                                                      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
                                                                                                      • 84. 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
                                                                                                        86. 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())
                                                                                                        88. 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())
                                                                                                        90. 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
                                                                                                        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()))
                                                                                                        92. 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.

                                                                                                        Control0..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.

                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        94. 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()))
                                                                                                        96. 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()))
                                                                                                        98. 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
                                                                                                        Summaryfalse
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        100. 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()))
                                                                                                        102. 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()))
                                                                                                        104. 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
                                                                                                        Summaryfalse
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        106. 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 ListEmptyReasons
                                                                                                        (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                                                        If a section is empty, why it is empty.

                                                                                                        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()))
                                                                                                        108. 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()))
                                                                                                        110. Composition.section:allergiesAdverseReactions
                                                                                                        Slice NameallergiesAdverseReactions
                                                                                                        Definition

                                                                                                        The root of the sections that make up the composition.

                                                                                                        ShortComposition is broken into sections
                                                                                                        Control1..1
                                                                                                        TypeBackboneElement
                                                                                                        Is Modifierfalse
                                                                                                        Must Supporttrue
                                                                                                        Obligations
                                                                                                          ObligationsActor
                                                                                                          SHALL:handleMHR Gateway Requester
                                                                                                          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()))
                                                                                                          112. Composition.section:allergiesAdverseReactions.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
                                                                                                          114. Composition.section:allergiesAdverseReactions.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())
                                                                                                          116. Composition.section:allergiesAdverseReactions.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())
                                                                                                          118. Composition.section:allergiesAdverseReactions.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.

                                                                                                          Control1..1
                                                                                                          Typestring
                                                                                                          Is Modifierfalse
                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                          Must Supporttrue
                                                                                                          Obligations
                                                                                                            ObligationsActor
                                                                                                            SHALL:handleMHR Gateway Requester
                                                                                                            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
                                                                                                            Fixed ValueAllergies and Adverse Reactions
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            120. Composition.section:allergiesAdverseReactions.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
                                                                                                            Must Supporttrue
                                                                                                            Obligations
                                                                                                              ObligationsActor
                                                                                                              SHALL:handleMHR Gateway Requester
                                                                                                              Summaryfalse
                                                                                                              Requirements

                                                                                                              Provides computable standardized labels to topics within the document.

                                                                                                              Pattern Value{
                                                                                                                "coding" : [{
                                                                                                                  "system" : "https://healthterminologies.gov.au/fhir/CodeSystem/nctis-data-components-1",
                                                                                                                  "code" : "101.20113",
                                                                                                                  "display" : "Adverse Reactions"
                                                                                                                }]
                                                                                                              }
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              122. Composition.section:allergiesAdverseReactions.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()))
                                                                                                              124. Composition.section:allergiesAdverseReactions.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()))
                                                                                                              126. Composition.section:allergiesAdverseReactions.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
                                                                                                              Summaryfalse
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              128. Composition.section:allergiesAdverseReactions.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.

                                                                                                              Control1..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
                                                                                                              Must Supporttrue
                                                                                                              Obligations
                                                                                                                ObligationsActor
                                                                                                                SHALL:handleMHR Gateway Requester
                                                                                                                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.

                                                                                                                Fixed Valuesnapshot
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                130. Composition.section:allergiesAdverseReactions.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()))
                                                                                                                132. Composition.section:allergiesAdverseReactions.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(MHR Medical Conditions View AllergyIntolerance)
                                                                                                                Is Modifierfalse
                                                                                                                Must Supporttrue
                                                                                                                Obligations
                                                                                                                  ObligationsActor
                                                                                                                  SHALL:handleMHR Gateway Requester
                                                                                                                  Summaryfalse
                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  134. Composition.section:allergiesAdverseReactions.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 ListEmptyReasons
                                                                                                                  (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                                                                  If a section is empty, why it is empty.

                                                                                                                  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()))
                                                                                                                  136. Composition.section:allergiesAdverseReactions.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()))
                                                                                                                  138. Composition.section:infoMedicalConditions
                                                                                                                  Slice NameinfoMedicalConditions
                                                                                                                  Definition

                                                                                                                  The root of the sections that make up the composition.

                                                                                                                  ShortComposition is broken into sections
                                                                                                                  Control1..1
                                                                                                                  TypeBackboneElement
                                                                                                                  Is Modifierfalse
                                                                                                                  Must Supporttrue
                                                                                                                  Obligations
                                                                                                                    ObligationsActor
                                                                                                                    SHALL:handleMHR Gateway Requester
                                                                                                                    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()))
                                                                                                                    140. Composition.section:infoMedicalConditions.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
                                                                                                                    142. Composition.section:infoMedicalConditions.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())
                                                                                                                    144. Composition.section:infoMedicalConditions.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())
                                                                                                                    146. Composition.section:infoMedicalConditions.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.

                                                                                                                    Control1..1
                                                                                                                    Typestring
                                                                                                                    Is Modifierfalse
                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                    Must Supporttrue
                                                                                                                    Obligations
                                                                                                                      ObligationsActor
                                                                                                                      SHALL:handleMHR Gateway Requester
                                                                                                                      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
                                                                                                                      Fixed ValueInformation on medical conditions, treatments and other history
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      148. Composition.section:infoMedicalConditions.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
                                                                                                                      Must Supporttrue
                                                                                                                      Obligations
                                                                                                                        ObligationsActor
                                                                                                                        SHALL:handleMHR Gateway Requester
                                                                                                                        Summaryfalse
                                                                                                                        Requirements

                                                                                                                        Provides computable standardized labels to topics within the document.

                                                                                                                        Pattern Value{
                                                                                                                          "coding" : [{
                                                                                                                            "system" : "https://healthterminologies.gov.au/fhir/CodeSystem/nctis-data-components-1",
                                                                                                                            "code" : "101.16117",
                                                                                                                            "display" : "Medical History"
                                                                                                                          }]
                                                                                                                        }
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        150. Composition.section:infoMedicalConditions.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()))
                                                                                                                        152. Composition.section:infoMedicalConditions.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()))
                                                                                                                        154. Composition.section:infoMedicalConditions.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
                                                                                                                        Summaryfalse
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        156. Composition.section:infoMedicalConditions.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.

                                                                                                                        Control1..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
                                                                                                                        Must Supporttrue
                                                                                                                        Obligations
                                                                                                                          ObligationsActor
                                                                                                                          SHALL:handleMHR Gateway Requester
                                                                                                                          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.

                                                                                                                          Fixed Valuesnapshot
                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          158. Composition.section:infoMedicalConditions.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()))
                                                                                                                          160. Composition.section:infoMedicalConditions.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(MHR Medical Conditions View Condition, MHR Medical Conditions View Explanation of Benefit, MHR Medical Conditions View Flag, MHR Medical Conditions View Observation, MHR Medical Conditions View Procedure)
                                                                                                                          Is Modifierfalse
                                                                                                                          Must Supporttrue
                                                                                                                          Must Support TypesNo must-support rules about the choice of types/profiles
                                                                                                                          Obligations
                                                                                                                            ObligationsActor
                                                                                                                            SHALL:handleMHR Gateway Requester
                                                                                                                            Summaryfalse
                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            162. Composition.section:infoMedicalConditions.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 ListEmptyReasons
                                                                                                                            (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                                                                                            If a section is empty, why it is empty.

                                                                                                                            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()))
                                                                                                                            164. Composition.section:infoMedicalConditions.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()))