My Health Record FHIR IG

My Health Record FHIR IG - Local Development build (v1.4.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

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Resource Profile: MHR Advance Care Planning Document DocumentReference

The purpose of this profile is to provide a representation of an Advance Care Planning Document document reference for the electronic exchange of health information between individuals, healthcare providers, and the My Health Record system infrastructure in Australia.

Usages:

• Refer to this Profile: MHR Advance Care Planning Document Composition
• Examples for this Profile: DocumentReference/acp-payload-01 and DocumentReference/acp-payload-02

Formal Views of Profile Content

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

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

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DocumentReference	C	0..*	DocumentReference	Advance Care Planning Document Constraints: inv-dh-docref-03
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
masterIdentifier	SΣ	0..1	Identifier	Master Version Specific Identifier
identifier	SΣ	1..*	Identifier	Other identifiers for the document
status	?!SΣ	1..1	code	current | superseded | entered-in-error Binding: DocumentReferenceStatus (required): The status of the document reference. Fixed Value: current
docStatus	SΣ	0..1	code	preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): Status of the underlying document. Required Pattern: final
type	SΣ	1..1	CodeableConcept	Sub type of advance care planning document Binding: Advance Care Planning Document Type (required)
Slices for category	SΣ	1..*	CodeableConcept	Categorization of document Slice: Unordered, Open by pattern:$this Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
category:aci	Σ	1..1	CodeableConcept	Advance Care Information Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://healthterminologies.gov.au/fhir/CodeSystem/nctis-data-components-1
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 100.16975
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subject	SΣC	1..1	Reference(MHR Patient)	Who/what is the subject of the document Constraints: inv-dh-docref-01
date	SΣ	1..1	instant	When this document reference was created
author	SΣC	0..1	Reference(MHR Authoring PractitionerRole | MHR Patient | MHR Authoring RelatedPerson)	Author of the attached advance care planning document Constraints: inv-dh-docref-02
authenticator	S	0..1	Reference(AU Core PractitionerRole | AU Core Organization)	Who/what authenticated the document
custodian	SC	0..1	Reference(AU Core Organization)	Organization which maintains the document
description	SΣ	0..1	string	Human-readable description
content	SΣ	1..1	BackboneElement	Document referenced
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
attachment	SΣ	1..1	Attachment	Where to access the document
context	SΣ	0..1	BackboneElement	Clinical context of document
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
encounter	S	0..*	Reference(MHR Encounter)	Context of the document content
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
DocumentReference.status	required	Fixed Value: current http://hl7.org/fhir/ValueSet/document-reference-status|4.0.1 From the FHIR Standard
DocumentReference.docStatus	required	Pattern Value: final http://hl7.org/fhir/ValueSet/composition-status|4.0.1 From the FHIR Standard
DocumentReference.type	required	AdvanceCarePlanningDocumentType https://healthterminologies.gov.au/fhir/ValueSet/advance-care-planning-document-type-1 From https://tx.ontoserver.csiro.au/fhir
DocumentReference.category	example	DocumentClassValueSet http://hl7.org/fhir/ValueSet/document-classcodes From the FHIR Standard
DocumentReference.category:aci	example	Pattern Value: 100.16975 http://hl7.org/fhir/ValueSet/document-classcodes From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	DocumentReference	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	DocumentReference	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	DocumentReference	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
inv-dh-docref-01	error	DocumentReference.subject	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-docref-02	error	DocumentReference.author	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-docref-03	error	DocumentReference	If present, a custodian shall at least have a reference or a valid identifier : custodian.exists() implies custodian.all($this.reference.exists() or $this.display.exists() or $this.identifier.where(system.count() + value.count() >1).exists())

This structure is derived from DocumentReference

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DocumentReference	C	0..*	DocumentReference	Advance Care Planning Document Constraints: inv-dh-docref-03
masterIdentifier	S	0..1	Identifier	Master Version Specific Identifier
identifier	S	1..*	Identifier	Other identifiers for the document
status	S	1..1	code	current | superseded | entered-in-error Fixed Value: current
docStatus	S	0..1	code	preliminary | final | amended | entered-in-error Required Pattern: final
type	S	1..1	CodeableConcept	Sub type of advance care planning document Binding: Advance Care Planning Document Type (required)
Slices for category	S	1..*	CodeableConcept	Categorization of document Slice: Unordered, Open by pattern:$this
category:aci		1..1	CodeableConcept	Advance Care Information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://healthterminologies.gov.au/fhir/CodeSystem/nctis-data-components-1
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 100.16975
subject	SC	1..1	Reference(MHR Patient)	Who/what is the subject of the document Constraints: inv-dh-docref-01
date	S	1..1	instant	When this document reference was created
author	SC	0..1	Reference(MHR Authoring PractitionerRole | MHR Patient | MHR Authoring RelatedPerson)	Author of the attached advance care planning document Constraints: inv-dh-docref-02
authenticator	S	0..1	Reference(AU Core PractitionerRole | AU Core Organization)	Who/what authenticated the document
custodian	SC	0..1	Reference(AU Core Organization)	Organization which maintains the document
description	S	0..1	string	Human-readable description
content	S	1..1	BackboneElement	Document referenced
attachment	S	1..1	Attachment	Where to access the document
context	S	0..1	BackboneElement	Clinical context of document
encounter	S	0..*	Reference(MHR Encounter)	Context of the document content
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
DocumentReference.type	required	AdvanceCarePlanningDocumentType https://healthterminologies.gov.au/fhir/ValueSet/advance-care-planning-document-type-1 From https://tx.ontoserver.csiro.au/fhir

Constraints

Id	Grade	Path(s)	Details	Requirements
inv-dh-docref-01	error	DocumentReference.subject	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-docref-02	error	DocumentReference.author	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-docref-03	error	DocumentReference	If present, a custodian shall at least have a reference or a valid identifier : custodian.exists() implies custodian.all($this.reference.exists() or $this.display.exists() or $this.identifier.where(system.count() + value.count() >1).exists())

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DocumentReference	C	0..*	DocumentReference	Advance Care Planning Document Constraints: inv-dh-docref-03
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
masterIdentifier	SΣ	0..1	Identifier	Master Version Specific Identifier
identifier	SΣ	1..*	Identifier	Other identifiers for the document
status	?!SΣ	1..1	code	current | superseded | entered-in-error Binding: DocumentReferenceStatus (required): The status of the document reference. Fixed Value: current
docStatus	SΣ	0..1	code	preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): Status of the underlying document. Required Pattern: final
type	SΣ	1..1	CodeableConcept	Sub type of advance care planning document Binding: Advance Care Planning Document Type (required)
Slices for category	SΣ	1..*	CodeableConcept	Categorization of document Slice: Unordered, Open by pattern:$this Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
category:aci	Σ	1..1	CodeableConcept	Advance Care Information Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://healthterminologies.gov.au/fhir/CodeSystem/nctis-data-components-1
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 100.16975
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subject	SΣC	1..1	Reference(MHR Patient)	Who/what is the subject of the document Constraints: inv-dh-docref-01
date	SΣ	1..1	instant	When this document reference was created
author	SΣC	0..1	Reference(MHR Authoring PractitionerRole | MHR Patient | MHR Authoring RelatedPerson)	Author of the attached advance care planning document Constraints: inv-dh-docref-02
authenticator	S	0..1	Reference(AU Core PractitionerRole | AU Core Organization)	Who/what authenticated the document
custodian	SC	0..1	Reference(AU Core Organization)	Organization which maintains the document
relatesTo	Σ	0..*	BackboneElement	Relationships to other documents
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	code	replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target	Σ	1..1	Reference(DocumentReference)	Target of the relationship
description	SΣ	0..1	string	Human-readable description
securityLabel	Σ	0..*	CodeableConcept	Document security-tags Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
content	SΣ	1..1	BackboneElement	Document referenced
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
attachment	SΣ	1..1	Attachment	Where to access the document
format	Σ	0..1	Coding	Format/content rules for the document Binding: DocumentReferenceFormatCodeSet (preferred): Document Format Codes.
context	SΣ	0..1	BackboneElement	Clinical context of document
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
encounter	S	0..*	Reference(MHR Encounter)	Context of the document content
event		0..*	CodeableConcept	Main clinical acts documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.
period	Σ	0..1	Period	Time of service that is being documented
facilityType		0..1	CodeableConcept	Kind of facility where patient was seen Binding: FacilityTypeCodeValueSet (example): XDS Facility Type.
practiceSetting		0..1	CodeableConcept	Additional details about where the content was created (e.g. clinical specialty) Binding: PracticeSettingCodeValueSet (example): Additional details about where the content was created (e.g. clinical specialty).
sourcePatientInfo		0..1	Reference(Patient)	Patient demographics from source
related		0..*	Reference(Resource)	Related identifiers or resources
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
DocumentReference.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
DocumentReference.status	required	Fixed Value: current http://hl7.org/fhir/ValueSet/document-reference-status|4.0.1 From the FHIR Standard
DocumentReference.docStatus	required	Pattern Value: final http://hl7.org/fhir/ValueSet/composition-status|4.0.1 From the FHIR Standard
DocumentReference.type	required	AdvanceCarePlanningDocumentType https://healthterminologies.gov.au/fhir/ValueSet/advance-care-planning-document-type-1 From https://tx.ontoserver.csiro.au/fhir
DocumentReference.category	example	DocumentClassValueSet http://hl7.org/fhir/ValueSet/document-classcodes From the FHIR Standard
DocumentReference.category:aci	example	Pattern Value: 100.16975 http://hl7.org/fhir/ValueSet/document-classcodes From the FHIR Standard
DocumentReference.relatesTo.code	required	DocumentRelationshipType http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1 From the FHIR Standard
DocumentReference.securityLabel	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels From the FHIR Standard
DocumentReference.content.format	preferred	DocumentReferenceFormatCodeSet(a valid code from http://ihe.net/fhir/ValueSet/IHE.FormatCode.codesystem) http://hl7.org/fhir/ValueSet/formatcodes From the FHIR Standard
DocumentReference.context.event	example	ActCode http://terminology.hl7.org/ValueSet/v3-ActCode
DocumentReference.context.facilityType	example	FacilityTypeCodeValueSet http://hl7.org/fhir/ValueSet/c80-facilitycodes From the FHIR Standard
DocumentReference.context.practiceSetting	example	PracticeSettingCodeValueSet http://hl7.org/fhir/ValueSet/c80-practice-codes From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	DocumentReference	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	DocumentReference	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	DocumentReference	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
inv-dh-docref-01	error	DocumentReference.subject	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-docref-02	error	DocumentReference.author	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-docref-03	error	DocumentReference	If present, a custodian shall at least have a reference or a valid identifier : custodian.exists() implies custodian.all($this.reference.exists() or $this.display.exists() or $this.identifier.where(system.count() + value.count() >1).exists())

This structure is derived from DocumentReference

Summary

Mandatory: 6 elements
Must-Support: 16 elements
Fixed: 1 element

Structures

This structure refers to these other structures:

• MHR Patient (http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-patient-mhr-1)
• MHR Authoring PractitionerRole (http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-practitionerrole-author-mhr-1)
• MHR Authoring RelatedPerson (http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-relatedperson-author-mhr-1)
• AU Core PractitionerRole (http://hl7.org.au/fhir/core/StructureDefinition/au-core-practitionerrole)
• AU Core Organization (http://hl7.org.au/fhir/core/StructureDefinition/au-core-organization)
• MHR Encounter (http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-encounter-mhr-1)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of DocumentReference.category

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DocumentReference	C	0..*	DocumentReference	Advance Care Planning Document Constraints: inv-dh-docref-03
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
masterIdentifier	SΣ	0..1	Identifier	Master Version Specific Identifier
identifier	SΣ	1..*	Identifier	Other identifiers for the document
status	?!SΣ	1..1	code	current | superseded | entered-in-error Binding: DocumentReferenceStatus (required): The status of the document reference. Fixed Value: current
docStatus	SΣ	0..1	code	preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): Status of the underlying document. Required Pattern: final
type	SΣ	1..1	CodeableConcept	Sub type of advance care planning document Binding: Advance Care Planning Document Type (required)
Slices for category	SΣ	1..*	CodeableConcept	Categorization of document Slice: Unordered, Open by pattern:$this Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
category:aci	Σ	1..1	CodeableConcept	Advance Care Information Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://healthterminologies.gov.au/fhir/CodeSystem/nctis-data-components-1
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 100.16975
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subject	SΣC	1..1	Reference(MHR Patient)	Who/what is the subject of the document Constraints: inv-dh-docref-01
date	SΣ	1..1	instant	When this document reference was created
author	SΣC	0..1	Reference(MHR Authoring PractitionerRole | MHR Patient | MHR Authoring RelatedPerson)	Author of the attached advance care planning document Constraints: inv-dh-docref-02
authenticator	S	0..1	Reference(AU Core PractitionerRole | AU Core Organization)	Who/what authenticated the document
custodian	SC	0..1	Reference(AU Core Organization)	Organization which maintains the document
description	SΣ	0..1	string	Human-readable description
content	SΣ	1..1	BackboneElement	Document referenced
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
attachment	SΣ	1..1	Attachment	Where to access the document
context	SΣ	0..1	BackboneElement	Clinical context of document
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
encounter	S	0..*	Reference(MHR Encounter)	Context of the document content
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
DocumentReference.status	required	Fixed Value: current http://hl7.org/fhir/ValueSet/document-reference-status|4.0.1 From the FHIR Standard
DocumentReference.docStatus	required	Pattern Value: final http://hl7.org/fhir/ValueSet/composition-status|4.0.1 From the FHIR Standard
DocumentReference.type	required	AdvanceCarePlanningDocumentType https://healthterminologies.gov.au/fhir/ValueSet/advance-care-planning-document-type-1 From https://tx.ontoserver.csiro.au/fhir
DocumentReference.category	example	DocumentClassValueSet http://hl7.org/fhir/ValueSet/document-classcodes From the FHIR Standard
DocumentReference.category:aci	example	Pattern Value: 100.16975 http://hl7.org/fhir/ValueSet/document-classcodes From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	DocumentReference	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	DocumentReference	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	DocumentReference	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
inv-dh-docref-01	error	DocumentReference.subject	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-docref-02	error	DocumentReference.author	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-docref-03	error	DocumentReference	If present, a custodian shall at least have a reference or a valid identifier : custodian.exists() implies custodian.all($this.reference.exists() or $this.display.exists() or $this.identifier.where(system.count() + value.count() >1).exists())

Differential View

This structure is derived from DocumentReference

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DocumentReference	C	0..*	DocumentReference	Advance Care Planning Document Constraints: inv-dh-docref-03
masterIdentifier	S	0..1	Identifier	Master Version Specific Identifier
identifier	S	1..*	Identifier	Other identifiers for the document
status	S	1..1	code	current | superseded | entered-in-error Fixed Value: current
docStatus	S	0..1	code	preliminary | final | amended | entered-in-error Required Pattern: final
type	S	1..1	CodeableConcept	Sub type of advance care planning document Binding: Advance Care Planning Document Type (required)
Slices for category	S	1..*	CodeableConcept	Categorization of document Slice: Unordered, Open by pattern:$this
category:aci		1..1	CodeableConcept	Advance Care Information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://healthterminologies.gov.au/fhir/CodeSystem/nctis-data-components-1
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 100.16975
subject	SC	1..1	Reference(MHR Patient)	Who/what is the subject of the document Constraints: inv-dh-docref-01
date	S	1..1	instant	When this document reference was created
author	SC	0..1	Reference(MHR Authoring PractitionerRole | MHR Patient | MHR Authoring RelatedPerson)	Author of the attached advance care planning document Constraints: inv-dh-docref-02
authenticator	S	0..1	Reference(AU Core PractitionerRole | AU Core Organization)	Who/what authenticated the document
custodian	SC	0..1	Reference(AU Core Organization)	Organization which maintains the document
description	S	0..1	string	Human-readable description
content	S	1..1	BackboneElement	Document referenced
attachment	S	1..1	Attachment	Where to access the document
context	S	0..1	BackboneElement	Clinical context of document
encounter	S	0..*	Reference(MHR Encounter)	Context of the document content
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
DocumentReference.type	required	AdvanceCarePlanningDocumentType https://healthterminologies.gov.au/fhir/ValueSet/advance-care-planning-document-type-1 From https://tx.ontoserver.csiro.au/fhir

Constraints

Id	Grade	Path(s)	Details	Requirements
inv-dh-docref-01	error	DocumentReference.subject	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-docref-02	error	DocumentReference.author	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-docref-03	error	DocumentReference	If present, a custodian shall at least have a reference or a valid identifier : custodian.exists() implies custodian.all($this.reference.exists() or $this.display.exists() or $this.identifier.where(system.count() + value.count() >1).exists())

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DocumentReference	C	0..*	DocumentReference	Advance Care Planning Document Constraints: inv-dh-docref-03
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
masterIdentifier	SΣ	0..1	Identifier	Master Version Specific Identifier
identifier	SΣ	1..*	Identifier	Other identifiers for the document
status	?!SΣ	1..1	code	current | superseded | entered-in-error Binding: DocumentReferenceStatus (required): The status of the document reference. Fixed Value: current
docStatus	SΣ	0..1	code	preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): Status of the underlying document. Required Pattern: final
type	SΣ	1..1	CodeableConcept	Sub type of advance care planning document Binding: Advance Care Planning Document Type (required)
Slices for category	SΣ	1..*	CodeableConcept	Categorization of document Slice: Unordered, Open by pattern:$this Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
category:aci	Σ	1..1	CodeableConcept	Advance Care Information Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://healthterminologies.gov.au/fhir/CodeSystem/nctis-data-components-1
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 100.16975
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subject	SΣC	1..1	Reference(MHR Patient)	Who/what is the subject of the document Constraints: inv-dh-docref-01
date	SΣ	1..1	instant	When this document reference was created
author	SΣC	0..1	Reference(MHR Authoring PractitionerRole | MHR Patient | MHR Authoring RelatedPerson)	Author of the attached advance care planning document Constraints: inv-dh-docref-02
authenticator	S	0..1	Reference(AU Core PractitionerRole | AU Core Organization)	Who/what authenticated the document
custodian	SC	0..1	Reference(AU Core Organization)	Organization which maintains the document
relatesTo	Σ	0..*	BackboneElement	Relationships to other documents
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	code	replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target	Σ	1..1	Reference(DocumentReference)	Target of the relationship
description	SΣ	0..1	string	Human-readable description
securityLabel	Σ	0..*	CodeableConcept	Document security-tags Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
content	SΣ	1..1	BackboneElement	Document referenced
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
attachment	SΣ	1..1	Attachment	Where to access the document
format	Σ	0..1	Coding	Format/content rules for the document Binding: DocumentReferenceFormatCodeSet (preferred): Document Format Codes.
context	SΣ	0..1	BackboneElement	Clinical context of document
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
encounter	S	0..*	Reference(MHR Encounter)	Context of the document content
event		0..*	CodeableConcept	Main clinical acts documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.
period	Σ	0..1	Period	Time of service that is being documented
facilityType		0..1	CodeableConcept	Kind of facility where patient was seen Binding: FacilityTypeCodeValueSet (example): XDS Facility Type.
practiceSetting		0..1	CodeableConcept	Additional details about where the content was created (e.g. clinical specialty) Binding: PracticeSettingCodeValueSet (example): Additional details about where the content was created (e.g. clinical specialty).
sourcePatientInfo		0..1	Reference(Patient)	Patient demographics from source
related		0..*	Reference(Resource)	Related identifiers or resources
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
DocumentReference.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
DocumentReference.status	required	Fixed Value: current http://hl7.org/fhir/ValueSet/document-reference-status|4.0.1 From the FHIR Standard
DocumentReference.docStatus	required	Pattern Value: final http://hl7.org/fhir/ValueSet/composition-status|4.0.1 From the FHIR Standard
DocumentReference.type	required	AdvanceCarePlanningDocumentType https://healthterminologies.gov.au/fhir/ValueSet/advance-care-planning-document-type-1 From https://tx.ontoserver.csiro.au/fhir
DocumentReference.category	example	DocumentClassValueSet http://hl7.org/fhir/ValueSet/document-classcodes From the FHIR Standard
DocumentReference.category:aci	example	Pattern Value: 100.16975 http://hl7.org/fhir/ValueSet/document-classcodes From the FHIR Standard
DocumentReference.relatesTo.code	required	DocumentRelationshipType http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1 From the FHIR Standard
DocumentReference.securityLabel	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels From the FHIR Standard
DocumentReference.content.format	preferred	DocumentReferenceFormatCodeSet(a valid code from http://ihe.net/fhir/ValueSet/IHE.FormatCode.codesystem) http://hl7.org/fhir/ValueSet/formatcodes From the FHIR Standard
DocumentReference.context.event	example	ActCode http://terminology.hl7.org/ValueSet/v3-ActCode
DocumentReference.context.facilityType	example	FacilityTypeCodeValueSet http://hl7.org/fhir/ValueSet/c80-facilitycodes From the FHIR Standard
DocumentReference.context.practiceSetting	example	PracticeSettingCodeValueSet http://hl7.org/fhir/ValueSet/c80-practice-codes From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	DocumentReference	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	DocumentReference	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	DocumentReference	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
inv-dh-docref-01	error	DocumentReference.subject	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-docref-02	error	DocumentReference.author	At least reference or a valid identifier shall be present : reference.exists() or identifier.where(system.count() + value.count() >1).exists()
inv-dh-docref-03	error	DocumentReference	If present, a custodian shall at least have a reference or a valid identifier : custodian.exists() implies custodian.all($this.reference.exists() or $this.display.exists() or $this.identifier.where(system.count() + value.count() >1).exists())

This structure is derived from DocumentReference

Summary

Mandatory: 6 elements
Must-Support: 16 elements
Fixed: 1 element

Structures

This structure refers to these other structures:

• MHR Patient (http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-patient-mhr-1)
• MHR Authoring PractitionerRole (http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-practitionerrole-author-mhr-1)
• MHR Authoring RelatedPerson (http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-relatedperson-author-mhr-1)
• AU Core PractitionerRole (http://hl7.org.au/fhir/core/StructureDefinition/au-core-practitionerrole)
• AU Core Organization (http://hl7.org.au/fhir/core/StructureDefinition/au-core-organization)
• MHR Encounter (http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-encounter-mhr-1)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of DocumentReference.category

Other representations of profile: CSV, Excel, Schematron