RIVO Noord Zorgviewer MVP2 Implementation Guide
0.2.1 - CI build
RIVO Noord Zorgviewer MVP2 Implementation Guide - Local Development build (v0.2.1). See the Directory of published versions
Draft as of 2023-03-22 |
Definitions for the DocumentReference resource profile.
Guidance on how to interpret the contents of this table can be found here.
1. DocumentReference | |
2. DocumentReference.status | |
Must Support | true |
Invariants | Defined on this element zv-dr-1: Only status is curreent final documents are expected. (: status='current') |
3. DocumentReference.type | |
4. DocumentReference.class | |
5. DocumentReference.indexed | |
6. DocumentReference.author | |
Comments | Expect the references Practitioner to have his Organization Contained resource of type Practitioner with: * authorInstitution: Organization * authorPerson: Practitioner.identifier and Practitioner.name * authorRole: — Not supported in STU3 * authorSpecialty: Practitioner.qualification * authorTelecommunication: Practitioner.telecom |
7. DocumentReference.description | |
Must Support | true |
8. DocumentReference.content | |
9. DocumentReference.content.attachment | |
Invariants | Defined on this element zv-dr-2: Only pdf documents are expected through the url (: content.attachement.contentType='application/pdf') |
10. DocumentReference.content.attachment.contentType | |
11. DocumentReference.content.attachment.url |
Guidance on how to interpret the contents of this table can be found here.
1. DocumentReference | |||||
Definition | A reference to a document. | ||||
Control | 0..* | ||||
Comments | Usually, this is used for documents other than those defined by FHIR. | ||||
Invariants | Defined on this element dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (: contained.text.empty()) dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (: contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (: contained.where(('#'+id in %resource.descendants().reference).not()).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()) | ||||
2. DocumentReference.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. | ||||
Control | 0..1 | ||||
Type | uri | ||||
Is Modifier | true | ||||
Summary | true | ||||
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. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation. | ||||
3. DocumentReference.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. Usually modifier elements provide negation or qualification. In order 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | true | ||||
Alternate Names | extensions, user content | ||||
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. | ||||
4. DocumentReference.masterIdentifier | |||||
Definition | Document identifier as assigned by the source of the document. This identifier is specific to this version of the document. This unique identifier may be used elsewhere to identify this version of the document. | ||||
Control | 10..1 | ||||
Type | Identifier | ||||
Must Support | true | ||||
Summary | true | ||||
Requirements | The structure and format of this Id shall be consistent with the specification corresponding to the formatCode attribute. (e.g. for a DICOM standard document a 64-character numeric UID, for an HL7 CDA format a serialization of the CDA Document Id extension and root in the form "oid^extension", where OID is a 64 digits max, and the Id is a 16 UTF-8 char max. If the OID is coded without the extension then the '^' character shall not be included.). | ||||
Comments | See ITI TF-2x: Z.9.1.1 Identifier and CDA root plus extension. CDA Document Id extension and root. | ||||
5. DocumentReference.identifier | |||||
Definition | Other identifiers associated with the document, including version independent identifiers. | ||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||
Control | 0..* | ||||
Type | Identifier | ||||
Must Support | true | ||||
Summary | true | ||||
Comments | When the DocumentReference.identifier carries the entryUUID then the DocumentReference.identifier use shall be ‘official’. | ||||
6. DocumentReference.status | |||||
Definition | The status of this document reference. | ||||
Control | 1..1 | ||||
Binding | The codes SHALL be taken from DocumentReferenceStatus The status of the document reference. | ||||
Type | code | ||||
Is Modifier | true | ||||
Must Support | true | ||||
Summary | true | ||||
Comments | approved -> status=current deprecated -> status=superseded This is the status of the DocumentReference object, which might be independent from the docStatus element. This element is labeled as a modifier because the status contains the codes that mark the document or reference as not currently valid. | ||||
Invariants | Defined on this element zv-dr-1: Only status is curreent final documents are expected. (: status='current') | ||||
7. DocumentReference.docStatus | |||||
Definition | The status of the underlying document. | ||||
Control | 0..01 | ||||
Binding | The codes SHALL be taken from CompositionStatus Status of the underlying document. | ||||
Type | code | ||||
Summary | true | ||||
Comments | These HL7 FHIR STU3 elements are not used in XDS, therefore would not be present. The document that is pointed to might be in various lifecycle states. | ||||
8. DocumentReference.type | |||||
Definition | Specifies the particular kind of document referenced (e.g. History and Physical, Discharge Summary, Progress Note). This usually equates to the purpose of making the document referenced. | ||||
Control | 1..1 | ||||
Binding | The codes SHOULD be taken from Document Type Value Set Precise type of clinical document. | ||||
Type | CodeableConcept | ||||
Must Support | true | ||||
Summary | true | ||||
Comments | Key metadata element describing the document, used in searching/filtering. | ||||
9. DocumentReference.class | |||||
Definition | A categorization for the type of document referenced - helps for indexing and searching. This may be implied by or derived from the code specified in the DocumentReference.type. | ||||
Control | 0..1 | ||||
Binding | For example codes, see Document Class Value Set High-level kind of a clinical document at a macro level. | ||||
Type | CodeableConcept | ||||
Must Support | true | ||||
Summary | true | ||||
Requirements | Helps humans to assess whether the document is of interest when viewing a list of documents. | ||||
Alternate Names | kind | ||||
Comments | This is a metadata field from XDS/MHD. | ||||
10. DocumentReference.subject | |||||
Definition | Who or what the document is about. The document 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 farm animals, or a set of patients that share a common exposure). | ||||
Control | 0..1 | ||||
Type | Reference(Patient|Practitioner|Group|Device) : {r}, {b} | ||||
Must Support | true | ||||
Summary | true | ||||
Comments | Not a contained resource. URL Points to an existing Patient Resource representing the XDS Affinity Domain Patient. | ||||
11. DocumentReference.created | |||||
Definition | When the document was created. | ||||
Control | 0..01 | ||||
Type | dateTime | ||||
Summary | true | ||||
Comments | Creation time is used for tracking, organizing versions and searching. This is the creation time of the document, not the source material on which it is based. | ||||
12. DocumentReference.indexed | |||||
Definition | When the document reference was created. | ||||
Control | 1..1 | ||||
Type | instant | ||||
Must Support | true | ||||
Summary | true | ||||
Comments | Referencing/indexing time is used for tracking, organizing versions and searching. | ||||
13. DocumentReference.author | |||||
Definition | Identifies who is responsible for adding the information to the document. | ||||
Control | 0..* | ||||
Type | Reference(Practitioner|Organization|Device|Patient|RelatedPerson) : {c} | ||||
Must Support | true | ||||
Must Support Types | No must-support rules about the choice of types/profiles | ||||
Summary | true | ||||
Comments | Expect the references Practitioner to have his Organization Not necessarily who did the actual data entry (i.e. typist) it in or who was the source (informant). | ||||
14. DocumentReference.custodian | |||||
Definition | Identifies the organization or group who is responsible for ongoing maintenance of and access to the document. | ||||
Control | 0..01 | ||||
Type | Reference(Organization) | ||||
Summary | true | ||||
Comments | These HL7 FHIR STU3 elements are not used in XDS, therefore would not be present. Identifies the logical organization to go to find the current version, where to report issues, etc. This is different from the physical location of the document, which is the technical location of the document, which host may be delegated to the management of some other organization. | ||||
15. DocumentReference.relatesTo | |||||
Definition | Relationships that this document has with other document references that already exist. | ||||
Control | 0..* | ||||
Type | BackboneElement | ||||
Is Modifier | true | ||||
Must Support | true | ||||
Summary | true | ||||
Comments | See ITI TF-2c: 3.65.4.1.2.3 This element is labeled as a modifier because documents that append to other documents are incomplete on their own. | ||||
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count())) | ||||
16. DocumentReference.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 that contains it. Usually modifier elements provide negation or qualification. In order 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | true | ||||
Summary | true | ||||
Alternate Names | extensions, user content, modifiers | ||||
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. | ||||
17. DocumentReference.relatesTo.code | |||||
Definition | The type of relationship that this document has with anther document. | ||||
Control | 1..1 | ||||
Binding | The codes SHALL be taken from DocumentRelationshipType The type of relationship between documents. | ||||
Type | code | ||||
Summary | true | ||||
Comments | If this document appends another document, then the document cannot be fully understood without also accessing the referenced document. | ||||
18. DocumentReference.relatesTo.target | |||||
Definition | The target document of this relationship. | ||||
Control | 1..1 | ||||
Type | Reference(DocumentReference) | ||||
Summary | true | ||||
19. DocumentReference.description | |||||
Definition | Human-readable description of the source document. This is sometimes known as the "title". | ||||
Control | 0..1 | ||||
Type | string | ||||
Must Support | true | ||||
Summary | true | ||||
Requirements | Helps humans to assess whether the document is of interest. | ||||
Comments | What the document is about, rather than a terse summary of the document. It is commonly the case that records do not have a title and are collectively referred to by the display name of Record code (e.g. a "consultation" or "progress note"). | ||||
20. DocumentReference.securityLabel | |||||
Definition | A set of Security-Tag codes specifying the level of privacy/security of the Document. Note that DocumentReference.meta.security contains the security labels of the "reference" to the document, while DocumentReference.securityLabel contains a snapshot of the security labels on the document the reference refers to. | ||||
Control | 0..* | ||||
Binding | The codes SHALL be taken from All Security Labels; other codes may be used where these codes are not suitable Security Labels from the Healthcare Privacy and Security Classification System. | ||||
Type | CodeableConcept | ||||
Must Support | true | ||||
Summary | true | ||||
Requirements | Use of the Health Care Privacy/Security Classification (HCS) system of security-tag use is recommended. | ||||
Comments | Note: This is NOT the DocumentReference.meta, as that holds the meta tags for the DocumentReference itself. The confidentiality codes can carry multiple vocabulary items. HL7 has developed an understanding of security and privacy tags that might be desirable in a Document Sharing environment, called HL7 Healthcare Privacy and Security Classification System (HCS). The following specification is recommended but not mandated, as the vocabulary bindings are an administrative domain responsibility. The use of this method is up to the policy domain such as the XDS Affinity Domain or other Trust Domain where all parties including sender and recipients are trusted to appropriately tag and enforce. In the HL7 Healthcare Privacy and Security Classification (HCS) there are code systems specific to Confidentiality, Sensitivity, Integrity, and Handling Caveats. Some values would come from a local vocabulary as they are related to workflow roles and special projects. | ||||
21. DocumentReference.content | |||||
Definition | The document and format referenced. There may be multiple content element repetitions, each with a different format. | ||||
Control | 1..1* | ||||
Type | BackboneElement | ||||
Must Support | true | ||||
Summary | true | ||||
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count())) | ||||
22. DocumentReference.content.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 that contains it. Usually modifier elements provide negation or qualification. In order 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | true | ||||
Summary | true | ||||
Alternate Names | extensions, user content, modifiers | ||||
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. | ||||
23. DocumentReference.content.attachment | |||||
Definition | The document or URL of the document along with critical metadata to prove content has integrity. | ||||
Control | 1..1 | ||||
Type | Attachment | ||||
Must Support | true | ||||
Summary | true | ||||
Invariants | Defined on this element zv-dr-2: Only pdf documents are expected through the url (: content.attachement.contentType='application/pdf') | ||||
24. DocumentReference.content.attachment.contentType | |||||
Definition | Identifies the type of the data in the attachment and allows a method to be chosen to interpret or render the data. Includes mime type parameters such as charset where appropriate. | ||||
Control | 10..1 | ||||
Binding | The codes SHALL be taken from mimetypes The mime type of an attachment. Any valid mime type is allowed. | ||||
Type | code | ||||
Must Support | true | ||||
Summary | true | ||||
Requirements | Processors of the data need to be able to know how to interpret the data. | ||||
Example | General:text/plain; charset=UTF-8, image/png | ||||
25. DocumentReference.content.attachment.language | |||||
Definition | The human language of the content. The value can be any valid value according to BCP 47. | ||||
Control | 0..1 | ||||
Binding | The codes SHALL be taken from Common Languages; other codes may be used where these codes are not suitable A human language.
| ||||
Type | code | ||||
Must Support | true | ||||
Summary | true | ||||
Requirements | Users need to be able to choose between the languages in a set of attachments. | ||||
Example | General:en-AU | ||||
26. DocumentReference.content.attachment.data | |||||
Definition | The actual data of the attachment - a sequence of bytes. In XML, represented using base64. | ||||
Control | 0..01 | ||||
Type | base64Binary | ||||
Requirements | The data needs to able to be transmitted inline. | ||||
Comments | These HL7 FHIR STU3 elements are not used in XDS, therefore would not be present. The base64-encoded data SHALL be expressed in the same character set as the base resource XML or JSON. | ||||
27. DocumentReference.content.attachment.url | |||||
Definition | An alternative location where the data can be accessed. | ||||
Control | 10..1 | ||||
Type | uri | ||||
Must Support | true | ||||
Summary | true | ||||
Requirements | The data needs to be transmitted by reference. | ||||
Comments | If both data and url are provided, the url SHALL point to the same content as the data contains. Urls may be relative references or may reference transient locations such as a wrapping envelope using cid: though this has ramifications for using signatures. Relative URLs are interpreted relative to the service url, like a resource reference, rather than relative to the resource itself. If a URL is provided, it SHALL resolve to actual data. | ||||
Example | General:http://www.acme.com/logo-small.png | ||||
28. DocumentReference.content.attachment.creation | |||||
Definition | The date that the attachment was first created. | ||||
Control | 0..01 | ||||
Type | dateTime | ||||
Summary | true | ||||
Requirements | This is often tracked as an integrity issue for use of the attachment. | ||||
Comments | These HL7 FHIR STU3 elements are not used in XDS, therefore would not be present. | ||||
29. DocumentReference.content.format | |||||
Definition | An identifier of the document encoding, structure, and template that the document conforms to beyond the base format indicated in the mimeType. | ||||
Control | 0..1 | ||||
Binding | The codes SHOULD be taken from IHE ValueSet of Format Codes for use with Document SharingThe codes SHOULD be taken from DocumentReference Format Code Set | ||||
Type | Coding | ||||
Must Support | true | ||||
Summary | true | ||||
Comments | Note that while IHE mostly issues URNs for format types, not all documents can be identified by a URI. | ||||
30. DocumentReference.context | |||||
Definition | The clinical context in which the document was prepared. | ||||
Control | 0..1 | ||||
Type | BackboneElement | ||||
Summary | true | ||||
Comments | These values are primarily added to help with searching for interesting/relevant documents. | ||||
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count())) | ||||
31. DocumentReference.context.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 that contains it. Usually modifier elements provide negation or qualification. In order 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | true | ||||
Summary | true | ||||
Alternate Names | extensions, user content, modifiers | ||||
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. | ||||
32. DocumentReference.context.period | |||||
Definition | The time period over which the service that is described by the document was provided. | ||||
Control | 0..1 | ||||
Type | Period | ||||
Must Support | true | ||||
Summary | true | ||||
33. DocumentReference.context.facilityType | |||||
Definition | The kind of facility where the patient was seen. | ||||
Control | 0..1 | ||||
Binding | For example codes, see Facility Type Code Value Set XDS Facility Type. | ||||
Type | CodeableConcept | ||||
Must Support | true | ||||
Summary | true | ||||
34. DocumentReference.context.practiceSetting | |||||
Definition | This property may convey specifics about the practice setting where the content was created, often reflecting the clinical specialty. | ||||
Control | 0..1 | ||||
Binding | For example codes, see Practice Setting Code Value Set Additional details about where the content was created (e.g. clinical specialty). | ||||
Type | CodeableConcept | ||||
Must Support | true | ||||
Summary | true | ||||
Requirements | This is an important piece of metadata that providers often rely upon to quickly sort and/or filter out to find specific content. | ||||
Comments | The value set for this content has an example binding because it is a value set decided by community policy. Other examples exist for consideration: * HITSP created the table HITSP/C80 Table 2-148 Clinical Specialty Value Set (a value set based upon SNOMED CT which is referenced by Direct (XDR and XDM for Direct Messaging Specification, Version 1), as well as Nationwide Health Information Network (NHIN). Query for Documents, Web Service Interface Specification, V 3.0, 07/27/2011 * ELGA (Austria) (ELGA CDA Implementie-rungsleitfäden Registrierung von CDA Dokumenten für ELGA mit IHE Cross-Enterprise Document Sharing: XDS Metadaten (XDSDocumentEntry), [1.2.40.0.34.7.6.3] * XDS Connect-a-thon practiceSettingCode. | ||||
35. DocumentReference.context.sourcePatientInfo | |||||
Definition | The Patient Information as known when the document was published. May be a reference to a version specific, or contained. | ||||
Control | 0..1 | ||||
Type | Reference(Patient) : {c} | ||||
Must Support | true | ||||
Summary | true | ||||
Comments | Contained Patient resource with Patient.identifier.use element set to ‘usual’. Indicates that the data within the XDS document entry be represented as a contained resource. See Section 4.5.4.4.7 |
Guidance on how to interpret the contents of this table can be found here.
1. DocumentReference | |||||
Definition | A reference to a document. | ||||
Control | 0..* | ||||
Comments | Usually, this is used for documents other than those defined by FHIR. | ||||
2. DocumentReference.id | |||||
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. | ||||
Control | 0..1 | ||||
Type | id | ||||
Summary | true | ||||
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. | ||||
3. DocumentReference.meta | |||||
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource. | ||||
Control | 0..1 | ||||
Type | Meta | ||||
Summary | true | ||||
4. DocumentReference.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. | ||||
Control | 0..1 | ||||
Type | uri | ||||
Is Modifier | true | ||||
Summary | true | ||||
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. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation. | ||||
5. DocumentReference.language | |||||
Definition | The base language in which the resource is written. | ||||
Control | 0..1 | ||||
Binding | The codes SHALL be taken from Common Languages; other codes may be used where these codes are not suitable
A human language
| ||||
Type | code | ||||
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). | ||||
6. DocumentReference.text | |||||
Definition | A human-readable narrative that contains a summary of the resource, and may 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. | ||||
Control | 0..1 This element is affected by the following invariants: dom-1 | ||||
Type | Narrative | ||||
Alternate Names | narrative, html, xhtml, display | ||||
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 in formation is added later. | ||||
7. DocumentReference.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. | ||||
Control | 0..* | ||||
Type | Resource | ||||
Alternate Names | inline resources, anonymous resources, contained 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. | ||||
8. DocumentReference.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the resource. In order 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Alternate Names | extensions, user content | ||||
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. | ||||
9. DocumentReference.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. Usually modifier elements provide negation or qualification. In order 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | true | ||||
Alternate Names | extensions, user content | ||||
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. | ||||
10. DocumentReference.masterIdentifier | |||||
Definition | Document identifier as assigned by the source of the document. This identifier is specific to this version of the document. This unique identifier may be used elsewhere to identify this version of the document. | ||||
Control | 1..1 | ||||
Type | Identifier | ||||
Must Support | true | ||||
Summary | true | ||||
Requirements | The structure and format of this Id shall be consistent with the specification corresponding to the formatCode attribute. (e.g. for a DICOM standard document a 64-character numeric UID, for an HL7 CDA format a serialization of the CDA Document Id extension and root in the form "oid^extension", where OID is a 64 digits max, and the Id is a 16 UTF-8 char max. If the OID is coded without the extension then the '^' character shall not be included.). | ||||
Comments | See ITI TF-2x: Z.9.1.1 Identifier and CDA root plus extension. | ||||
11. DocumentReference.identifier | |||||
Definition | Other identifiers associated with the document, including version independent identifiers. | ||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||
Control | 0..* | ||||
Type | Identifier | ||||
Must Support | true | ||||
Summary | true | ||||
Comments | When the DocumentReference.identifier carries the entryUUID then the DocumentReference.identifier use shall be ‘official’. | ||||
12. DocumentReference.status | |||||
Definition | The status of this document reference. | ||||
Control | 1..1 | ||||
Binding | The codes SHALL be taken from DocumentReferenceStatus The status of the document reference | ||||
Type | code | ||||
Is Modifier | true | ||||
Must Support | true | ||||
Summary | true | ||||
Comments | approved -> status=current deprecated -> status=superseded | ||||
Invariants | Defined on this element zv-dr-1: Only status is curreent final documents are expected. (: status='current') | ||||
13. DocumentReference.docStatus | |||||
Definition | The status of the underlying document. | ||||
Control | 0..0 | ||||
Binding | The codes SHALL be taken from CompositionStatus Status of the underlying document | ||||
Type | code | ||||
Summary | true | ||||
Comments | These HL7 FHIR STU3 elements are not used in XDS, therefore would not be present. | ||||
14. DocumentReference.type | |||||
Definition | Specifies the particular kind of document referenced (e.g. History and Physical, Discharge Summary, Progress Note). This usually equates to the purpose of making the document referenced. | ||||
Control | 1..1 | ||||
Binding | The codes SHOULD be taken from Document Type Value Set Precise type of clinical document | ||||
Type | CodeableConcept | ||||
Must Support | true | ||||
Summary | true | ||||
Comments | Key metadata element describing the document, used in searching/filtering. | ||||
15. DocumentReference.class | |||||
Definition | A categorization for the type of document referenced - helps for indexing and searching. This may be implied by or derived from the code specified in the DocumentReference.type. | ||||
Control | 0..1 | ||||
Binding | For example codes, see Document Class Value Set High-level kind of a clinical document at a macro level | ||||
Type | CodeableConcept | ||||
Must Support | true | ||||
Summary | true | ||||
Requirements | Helps humans to assess whether the document is of interest when viewing a list of documents. | ||||
Alternate Names | kind | ||||
Comments | This is a metadata field from XDS/MHD. | ||||
16. DocumentReference.subject | |||||
Definition | Who or what the document is about. The document 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 farm animals, or a set of patients that share a common exposure). | ||||
Control | 0..1 | ||||
Type | Reference(Patient) : {r}, {b} | ||||
Must Support | true | ||||
Summary | true | ||||
Comments | Not a contained resource. URL Points to an existing Patient Resource representing the XDS Affinity Domain Patient. | ||||
17. DocumentReference.created | |||||
Definition | When the document was created. | ||||
Control | 0..0 | ||||
Type | dateTime | ||||
Summary | true | ||||
Comments | Creation time is used for tracking, organizing versions and searching. This is the creation time of the document, not the source material on which it is based. | ||||
18. DocumentReference.indexed | |||||
Definition | When the document reference was created. | ||||
Control | 1..1 | ||||
Type | instant | ||||
Must Support | true | ||||
Summary | true | ||||
Comments | Referencing/indexing time is used for tracking, organizing versions and searching. | ||||
19. DocumentReference.author | |||||
Definition | Identifies who is responsible for adding the information to the document. | ||||
Control | 0..* | ||||
Type | Reference(Practitioner|Organization) : {c} | ||||
Must Support | true | ||||
Must Support Types | No must-support rules about the choice of types/profiles | ||||
Summary | true | ||||
Comments | Expect the references Practitioner to have his Organization | ||||
20. DocumentReference.authenticator | |||||
Definition | Which person or organization authenticates that this document is valid. | ||||
Control | 0..1 | ||||
Type | Reference | ||||
Summary | true | ||||
Comments | Contained resource | ||||
21. DocumentReference.custodian | |||||
Definition | Identifies the organization or group who is responsible for ongoing maintenance of and access to the document. | ||||
Control | 0..0 | ||||
Type | Reference(Organization) | ||||
Summary | true | ||||
Comments | These HL7 FHIR STU3 elements are not used in XDS, therefore would not be present. | ||||
22. DocumentReference.relatesTo | |||||
Definition | Relationships that this document has with other document references that already exist. | ||||
Control | 0..* | ||||
Type | BackboneElement | ||||
Is Modifier | true | ||||
Must Support | true | ||||
Summary | true | ||||
Comments | See ITI TF-2c: 3.65.4.1.2.3 | ||||
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count())) | ||||
23. DocumentReference.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. | ||||
Control | 0..1 | ||||
Type | string | ||||
XML Representation | In the XML format, this property is represented as an attribute. | ||||
24. DocumentReference.relatesTo.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Alternate Names | extensions, user content | ||||
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. | ||||
25. DocumentReference.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 that contains it. Usually modifier elements provide negation or qualification. In order 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | true | ||||
Summary | true | ||||
Alternate Names | extensions, user content, modifiers | ||||
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. | ||||
26. DocumentReference.relatesTo.code | |||||
Definition | The type of relationship that this document has with anther document. | ||||
Control | 1..1 | ||||
Binding | The codes SHALL be taken from DocumentRelationshipType The type of relationship between documents | ||||
Type | code | ||||
Summary | true | ||||
Comments | If this document appends another document, then the document cannot be fully understood without also accessing the referenced document. | ||||
27. DocumentReference.relatesTo.target | |||||
Definition | The target document of this relationship. | ||||
Control | 1..1 | ||||
Type | Reference(DocumentReference) | ||||
Summary | true | ||||
28. DocumentReference.description | |||||
Definition | Human-readable description of the source document. This is sometimes known as the "title". | ||||
Control | 0..1 | ||||
Type | string | ||||
Must Support | true | ||||
Summary | true | ||||
Requirements | Helps humans to assess whether the document is of interest. | ||||
Comments | What the document is about, rather than a terse summary of the document. It is commonly the case that records do not have a title and are collectively referred to by the display name of Record code (e.g. a "consultation" or "progress note"). | ||||
29. DocumentReference.securityLabel | |||||
Definition | A set of Security-Tag codes specifying the level of privacy/security of the Document. Note that DocumentReference.meta.security contains the security labels of the "reference" to the document, while DocumentReference.securityLabel contains a snapshot of the security labels on the document the reference refers to. | ||||
Control | 0..* | ||||
Binding | The codes SHALL be taken from All Security Labels; other codes may be used where these codes are not suitable Security Labels from the Healthcare Privacy and Security Classification System | ||||
Type | CodeableConcept | ||||
Must Support | true | ||||
Summary | true | ||||
Requirements | Use of the Health Care Privacy/Security Classification (HCS) system of security-tag use is recommended. | ||||
Comments | Note: This is NOT the DocumentReference.meta, as that holds the meta tags for the DocumentReference itself. | ||||
30. DocumentReference.content | |||||
Definition | The document and format referenced. There may be multiple content element repetitions, each with a different format. | ||||
Control | 1..1 | ||||
Type | BackboneElement | ||||
Must Support | true | ||||
Summary | true | ||||
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count())) | ||||
31. DocumentReference.content.id | |||||
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Control | 0..1 | ||||
Type | string | ||||
XML Representation | In the XML format, this property is represented as an attribute. | ||||
32. DocumentReference.content.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Alternate Names | extensions, user content | ||||
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. | ||||
33. DocumentReference.content.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 that contains it. Usually modifier elements provide negation or qualification. In order 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | true | ||||
Summary | true | ||||
Alternate Names | extensions, user content, modifiers | ||||
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. | ||||
34. DocumentReference.content.attachment | |||||
Definition | The document or URL of the document along with critical metadata to prove content has integrity. | ||||
Control | 1..1 | ||||
Type | Attachment | ||||
Must Support | true | ||||
Summary | true | ||||
Invariants | Defined on this element zv-dr-2: Only pdf documents are expected through the url (: content.attachement.contentType='application/pdf') | ||||
35. DocumentReference.content.attachment.id | |||||
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Control | 0..1 | ||||
Type | string | ||||
XML Representation | In the XML format, this property is represented as an attribute. | ||||
36. DocumentReference.content.attachment.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Alternate Names | extensions, user content | ||||
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. | ||||
Slicing | This element introduces a set of slices on DocumentReference.content.attachment.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
| ||||
37. DocumentReference.content.attachment.contentType | |||||
Definition | Identifies the type of the data in the attachment and allows a method to be chosen to interpret or render the data. Includes mime type parameters such as charset where appropriate. | ||||
Control | 1..1 | ||||
Binding | The codes SHALL be taken from mimetypes The mime type of an attachment. Any valid mime type is allowed | ||||
Type | code | ||||
Must Support | true | ||||
Summary | true | ||||
Requirements | Processors of the data need to be able to know how to interpret the data. | ||||
Example | General:text/plain; charset=UTF-8, image/png | ||||
38. DocumentReference.content.attachment.language | |||||
Definition | The human language of the content. The value can be any valid value according to BCP 47. | ||||
Control | 0..1 | ||||
Binding | The codes SHALL be taken from Common Languages; other codes may be used where these codes are not suitable
A human language
| ||||
Type | code | ||||
Must Support | true | ||||
Summary | true | ||||
Requirements | Users need to be able to choose between the languages in a set of attachments. | ||||
Example | General:en-AU | ||||
39. DocumentReference.content.attachment.data | |||||
Definition | The actual data of the attachment - a sequence of bytes. In XML, represented using base64. | ||||
Control | 0..0 | ||||
Type | base64Binary | ||||
Requirements | The data needs to able to be transmitted inline. | ||||
Comments | These HL7 FHIR STU3 elements are not used in XDS, therefore would not be present. | ||||
40. DocumentReference.content.attachment.url | |||||
Definition | An alternative location where the data can be accessed. | ||||
Control | 1..1 | ||||
Type | uri | ||||
Must Support | true | ||||
Summary | true | ||||
Requirements | The data needs to be transmitted by reference. | ||||
Comments | If both data and url are provided, the url SHALL point to the same content as the data contains. Urls may be relative references or may reference transient locations such as a wrapping envelope using cid: though this has ramifications for using signatures. Relative URLs are interpreted relative to the service url, like a resource reference, rather than relative to the resource itself. If a URL is provided, it SHALL resolve to actual data. | ||||
Example | General:http://www.acme.com/logo-small.png | ||||
41. DocumentReference.content.attachment.size | |||||
Definition | The number of bytes of data that make up this attachment (before base64 encoding, if that is done). | ||||
Control | 0..1 | ||||
Type | unsignedInt | ||||
Summary | true | ||||
Requirements | Representing the size allows applications to determine whether they should fetch the content automatically in advance, or refuse to fetch it at all. | ||||
Comments | The size is calculated on the data prior to base64 encoding, if the data is base64 encoded. | ||||
42. DocumentReference.content.attachment.hash | |||||
Definition | The calculated hash of the data using SHA-1. Represented using base64. | ||||
Control | 0..1 | ||||
Type | base64Binary | ||||
Summary | true | ||||
Requirements | Included so that applications can verify that the contents of a location have not changed and so that a signature of the content can implicitly sign the content of an image without having to include the data in the instance or reference the url in the signature. | ||||
Comments | The IHE Document Sharing metadata element hash holds the SHA1 hash of the document. The hash is encoded in FHIR in base64Binary, whereas in XDS hexbinary is used. The hash is calculated on the data prior to base64 encoding, if the data is base64 encoded. | ||||
43. DocumentReference.content.attachment.title | |||||
Definition | A label or set of text to display in place of the data. | ||||
Control | 0..1 | ||||
Type | string | ||||
Summary | true | ||||
Requirements | Applications need a label to display to a human user in place of the actual data if the data cannot be rendered or perceived by the viewer. | ||||
Example | General:Official Corporate Logo | ||||
44. DocumentReference.content.attachment.creation | |||||
Definition | The date that the attachment was first created. | ||||
Control | 0..0 | ||||
Type | dateTime | ||||
Summary | true | ||||
Requirements | This is often tracked as an integrity issue for use of the attachment. | ||||
Comments | These HL7 FHIR STU3 elements are not used in XDS, therefore would not be present. | ||||
45. DocumentReference.content.format | |||||
Definition | An identifier of the document encoding, structure, and template that the document conforms to beyond the base format indicated in the mimeType. | ||||
Control | 0..1 | ||||
Binding | The codes SHOULD be taken from IHE ValueSet of Format Codes for use with Document Sharing | ||||
Type | Coding | ||||
Must Support | true | ||||
Summary | true | ||||
Comments | Note that while IHE mostly issues URNs for format types, not all documents can be identified by a URI. | ||||
46. DocumentReference.context | |||||
Definition | The clinical context in which the document was prepared. | ||||
Control | 0..1 | ||||
Type | BackboneElement | ||||
Summary | true | ||||
Comments | These values are primarily added to help with searching for interesting/relevant documents. | ||||
47. DocumentReference.context.id | |||||
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Control | 0..1 | ||||
Type | string | ||||
XML Representation | In the XML format, this property is represented as an attribute. | ||||
48. DocumentReference.context.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Alternate Names | extensions, user content | ||||
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. | ||||
49. DocumentReference.context.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 that contains it. Usually modifier elements provide negation or qualification. In order 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | true | ||||
Summary | true | ||||
Alternate Names | extensions, user content, modifiers | ||||
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. | ||||
50. DocumentReference.context.encounter | |||||
Definition | Describes the clinical encounter or type of care that the document content is associated with. | ||||
Control | 0..1 | ||||
Type | Reference(Encounter) | ||||
Summary | true | ||||
Comments | When referenceIdList contains an encounter, and a FHIR Encounter is available, it may be referenced. | ||||
51. DocumentReference.context.event | |||||
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. | ||||
Control | 0..* | ||||
Binding | For example codes, see ActCode This list of codes represents the main clinical acts being documented | ||||
Type | CodeableConcept | ||||
Summary | true | ||||
Comments | An event can further specialize the act inherent in the type, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more event codes are included, they shall not conflict with the values inherent in the class or type elements as such a conflict would create an ambiguous situation. | ||||
52. DocumentReference.context.period | |||||
Definition | The time period over which the service that is described by the document was provided. | ||||
Control | 0..1 | ||||
Type | Period | ||||
Must Support | true | ||||
Summary | true | ||||
53. DocumentReference.context.facilityType | |||||
Definition | The kind of facility where the patient was seen. | ||||
Control | 0..1 | ||||
Binding | For example codes, see Facility Type Code Value Set XDS Facility Type | ||||
Type | CodeableConcept | ||||
Must Support | true | ||||
Summary | true | ||||
54. DocumentReference.context.practiceSetting | |||||
Definition | This property may convey specifics about the practice setting where the content was created, often reflecting the clinical specialty. | ||||
Control | 0..1 | ||||
Binding | For example codes, see Practice Setting Code Value Set Additional details about where the content was created (e.g. clinical specialty) | ||||
Type | CodeableConcept | ||||
Must Support | true | ||||
Summary | true | ||||
Requirements | This is an important piece of metadata that providers often rely upon to quickly sort and/or filter out to find specific content. | ||||
Comments | The value set for this content has an example binding because it is a value set decided by community policy. Other examples exist for consideration: * HITSP created the table HITSP/C80 Table 2-148 Clinical Specialty Value Set (a value set based upon SNOMED CT which is referenced by Direct (XDR and XDM for Direct Messaging Specification, Version 1), as well as Nationwide Health Information Network (NHIN). Query for Documents, Web Service Interface Specification, V 3.0, 07/27/2011 * ELGA (Austria) (ELGA CDA Implementie-rungsleitfäden Registrierung von CDA Dokumenten für ELGA mit IHE Cross-Enterprise Document Sharing: XDS Metadaten (XDSDocumentEntry), [1.2.40.0.34.7.6.3] * XDS Connect-a-thon practiceSettingCode. | ||||
55. DocumentReference.context.sourcePatientInfo | |||||
Definition | The Patient Information as known when the document was published. May be a reference to a version specific, or contained. | ||||
Control | 0..1 | ||||
Type | Reference | ||||
Must Support | true | ||||
Summary | true | ||||
Comments | Contained Patient resource with Patient.identifier.use element set to ‘usual’. Indicates that the data within the XDS document entry be represented as a contained resource. See Section 4.5.4.4.7 | ||||
56. DocumentReference.context.related | |||||
Definition | Related identifiers or resources associated with the DocumentReference. | ||||
Control | 0..* | ||||
Type | BackboneElement | ||||
Summary | true | ||||
Comments | May be identifiers or resources that caused the DocumentReference or referenced Document to be created. | ||||
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() | (children().count() > id.count())) | ||||
57. DocumentReference.context.related.id | |||||
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Control | 0..1 | ||||
Type | string | ||||
XML Representation | In the XML format, this property is represented as an attribute. | ||||
58. DocumentReference.context.related.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Alternate Names | extensions, user content | ||||
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. | ||||
59. DocumentReference.context.related.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 that contains it. Usually modifier elements provide negation or qualification. In order 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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | true | ||||
Summary | true | ||||
Alternate Names | extensions, user content, modifiers | ||||
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. | ||||
60. DocumentReference.context.related.identifier | |||||
Definition | Related identifier to this DocumentReference. If both id and ref are present they shall refer to the same thing. | ||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||
Control | 0..1 | ||||
Type | Identifier | ||||
Summary | true | ||||
Comments | See ITI TF-2x: Appendix E.3.1 on CXi mapping to FHIR Identifier | ||||
61. DocumentReference.context.related.ref | |||||
Definition | Related Resource to this DocumentReference. If both id and ref are present they shall refer to the same thing. | ||||
Control | 0..1 | ||||
Type | Reference(Resource) | ||||
Summary | true | ||||
Comments | May be filled with URL pointers to Resources found in referenceIdList |