ESMD FHIR Implementation Guide
1.0.0 - esmd

ESMD FHIR Implementation Guide - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: Esmd Document Reference Profile

Official URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-FindDocumentReference Version: 1.0.0
Draft as of 2024-02-25 Computable Name: EsmdFindDocumentReference

The Esmd-FindDocumentReference profile extends the HL7 DocumentReference resource. It is used as a component of the Esmd-FindBundleDocumentReferences bundle resource to provide document metadata and the Binary URL (storage URL) for each clinical document payload or system reference data file that the requesting HIH is authorized to retrieve. HIHs use the Binary URL to download or redownload the base64 binary encoded content of clinical documents and esMD system reference data files from the esMD System's secure storage.

Usage:

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraintsdoco
.. DocumentReference 0..* DocumentReference A reference to a document
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
dom-6: A resource should have narrative for robust management
... meta SΣ 0..1 EsmdMeta Metadata about the resource
ele-1: All FHIR elements must have a @value or children
.... profile Σ 1..* canonical(StructureDefinition) Profiles this resource claims to conform to
Slice: Unordered, Open by value:$this
ele-1: All FHIR elements must have a @value or children
.... security SΣC 0..* Coding Security Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


ele-1: All FHIR elements must have a @value or children
inv-esmd-meta-security-01: esMD supports only V security code
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
ele-1: All FHIR elements must have a @value or children
... Slices for extension S 5..* Extension Extension
Slice: Unordered, Open by value:url
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... extension:esmdTransactionId S 1..* string ESMD Transaction ID
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-TransactionId
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... extension:organizationId S 1..1 string HIH Organization ID
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-OrganizationId
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... extension:reviewContractorOid S 1..1 code esMD Receiver OID
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-ReviewContractorOid
Binding: ESMD ReviewContractorOIDs ValueSet (required)
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... extension:npi S 0..1 string esMD Provider NPI
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-NPI
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... extension:requestType S 0..1 string Request Type
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-RequestType
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... extension:linesOfBusinessId S 1..1 code esMD support Lines of Business
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-LinesOfBusinessId
Binding: esMD Lines Of Business ValueSet (required)
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... extension:statusCode S 1..1 code Status Code
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-StatusCode
Binding: ESMD StatusCodes ValueSet (required): Codes used for esMD Custom Status Codes


ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... identifier:Esmd-Idn-UniqueId Σ 0..1 Identifier Other identifiers for the document
ele-1: All FHIR elements must have a @value or children
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


ele-1: All FHIR elements must have a @value or children
..... system Σ 1..1 uri The namespace for the identifier value
ele-1: All FHIR elements must have a @value or children
Fixed Value: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Idn-UniqueId
.... identifier:Esmd-Idn-LetterId Σ 0..1 Identifier Other identifiers for the document
ele-1: All FHIR elements must have a @value or children
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


ele-1: All FHIR elements must have a @value or children
..... system Σ 1..1 uri The namespace for the identifier value
ele-1: All FHIR elements must have a @value or children
Fixed Value: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Idn-LetterId
... status ?!SΣ 1..1 code current | superseded | entered-in-error
Binding: DocumentReferenceStatus (required): The status of the document reference.


ele-1: All FHIR elements must have a @value or children
Required Pattern: current
... type SΣ 0..1 CodeableConcept Kind of document (LOINC if possible)
Binding: DocumentTypeValueSet (preferred): Precise type of clinical document.


ele-1: All FHIR elements must have a @value or children
... category SΣ 0..1 CodeableConcept Categorization of document
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.


ele-1: All FHIR elements must have a @value or children
... subject SΣ 0..1 Reference(Patient) Who/what is the subject of the document
ele-1: All FHIR elements must have a @value or children
... date SΣ 1..1 instant When this document reference was created
ele-1: All FHIR elements must have a @value or children
... author SΣ 0..* Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson) Who and/or what authored the document
ele-1: All FHIR elements must have a @value or children
... relatesTo SΣ 0..* BackboneElement Relationships to other documents
ele-1: All FHIR elements must have a @value or children
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... code Σ 1..1 code replaces | transforms | signs | appends
Binding: DocumentRelationshipType (required): The type of relationship between documents.


ele-1: All FHIR elements must have a @value or children
.... target Σ 1..1 Reference(DocumentReference) Target of the relationship
ele-1: All FHIR elements must have a @value or children
... securityLabel SΣ 1..* CodeableConcept Document security-tags
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


ele-1: All FHIR elements must have a @value or children
... content Σ 1..* BackboneElement Document referenced
ele-1: All FHIR elements must have a @value or children
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... attachment Σ 1..1 Attachment Where to access the document
ele-1: All FHIR elements must have a @value or children
..... id S 1..1 string Unique id for inter-element referencing
..... contentType SΣ 1..1 code Mime type of the content, with charset etc.
Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed.


ele-1: All FHIR elements must have a @value or children
Example General: text/plain; charset=UTF-8, image/png
..... language SΣ 0..1 code Human language of the content (BCP-47)
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding

ele-1: All FHIR elements must have a @value or children
Example General: en-AU
..... url SΣ 1..1 url Uri where the data can be found
ele-1: All FHIR elements must have a @value or children
Example General: http://www.acme.com/logo-small.png
..... size SΣ 1..1 unsignedInt Number of bytes of content (if url provided)
ele-1: All FHIR elements must have a @value or children
..... hash SΣ 1..1 base64Binary Hash of the data (sha-1, base64ed)
ele-1: All FHIR elements must have a @value or children
..... title SΣ 1..1 string Label to display in place of the data
ele-1: All FHIR elements must have a @value or children
Example General: Official Corporate Logo
..... creation SΣ 1..1 dateTime Date attachment was first created
ele-1: All FHIR elements must have a @value or children
... context Σ 1..1 BackboneElement Clinical context of document
ele-1: All FHIR elements must have a @value or children
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... facilityType 1..1 CodeableConcept Kind of facility where patient was seen
Binding: FacilityTypeCodeValueSet (example): XDS Facility Type.


ele-1: All FHIR elements must have a @value or children

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
DocumentReference.meta.securityextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
DocumentReference.identifier:Esmd-Idn-UniqueId.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
DocumentReference.identifier:Esmd-Idn-LetterId.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
DocumentReference.statusrequiredPattern: current
http://hl7.org/fhir/ValueSet/document-reference-status|4.0.1
from the FHIR Standard
DocumentReference.typepreferredDocumentTypeValueSet
http://hl7.org/fhir/ValueSet/c80-doc-typecodes
from the FHIR Standard
DocumentReference.categoryexampleDocumentClassValueSet
http://hl7.org/fhir/ValueSet/document-classcodes
from the FHIR Standard
DocumentReference.relatesTo.coderequiredDocumentRelationshipType
http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1
from the FHIR Standard
DocumentReference.securityLabelextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
DocumentReference.content.attachment.contentTyperequiredMime Types (a valid code from urn:ietf:bcp:13)
http://hl7.org/fhir/ValueSet/mimetypes|4.0.1
from the FHIR Standard
DocumentReference.content.attachment.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
DocumentReference.context.facilityTypeexampleFacilityTypeCodeValueSet
http://hl7.org/fhir/ValueSet/c80-facilitycodes
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorDocumentReferenceIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorDocumentReferenceIf 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-4errorDocumentReferenceIf 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-5errorDocumentReferenceIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceDocumentReferenceA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
inv-esmd-meta-security-01errorDocumentReference.meta.securityesMD supports only V security code
: code.exists() implies (code = 'V' or code = 'HTEST')

This structure is derived from DocumentReference

NameFlagsCard.TypeDescription & Constraintsdoco
.. DocumentReference DocumentReference
... meta S 0..1 EsmdMeta Metadata about the resource
.... security S 0..* Coding Security Labels applied to this resource
... Slices for extension S 5..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:esmdTransactionId S 1..* string ESMD Transaction ID
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-TransactionId
.... extension:organizationId S 1..1 string HIH Organization ID
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-OrganizationId
.... extension:reviewContractorOid S 1..1 code esMD Receiver OID
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-ReviewContractorOid
Binding: ESMD ReviewContractorOIDs ValueSet (required)
.... extension:npi S 0..1 string esMD Provider NPI
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-NPI
.... extension:requestType S 0..1 string Request Type
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-RequestType
.... extension:linesOfBusinessId S 1..1 code esMD support Lines of Business
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-LinesOfBusinessId
Binding: esMD Lines Of Business ValueSet (required)
.... extension:statusCode S 1..1 code Status Code
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-StatusCode
Binding: ESMD StatusCodes ValueSet (required): Codes used for esMD Custom Status Codes

... modifierExtension 0..0
.... identifier:Esmd-Idn-UniqueId 0..1 Identifier Other identifiers for the document
..... system 1..1 uri The namespace for the identifier value
Fixed Value: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Idn-UniqueId
.... identifier:Esmd-Idn-LetterId 0..1 Identifier Other identifiers for the document
..... system 1..1 uri The namespace for the identifier value
Fixed Value: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Idn-LetterId
... status S 1..1 code current | superseded | entered-in-error
Required Pattern: current
... docStatus 0..0
... type S 0..1 CodeableConcept Kind of document (LOINC if possible)
... category S 0..1 CodeableConcept Categorization of document
... subject S 0..1 Reference(Patient) Who/what is the subject of the document
... date S 1..1 instant When this document reference was created
... author S 0..* Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson) Who and/or what authored the document
... relatesTo S 0..* BackboneElement Relationships to other documents
... securityLabel S 1..* CodeableConcept Document security-tags
... content 1..* BackboneElement Document referenced
.... attachment
..... id S 1..1 string Unique id for inter-element referencing
..... contentType S 1..1 code Mime type of the content, with charset etc.
..... language S 0..1 code Human language of the content (BCP-47)
..... data 0..0
..... url S 1..1 url Uri where the data can be found
..... size S 1..1 unsignedInt Number of bytes of content (if url provided)
..... hash S 1..1 base64Binary Hash of the data (sha-1, base64ed)
..... title S 1..1 string Label to display in place of the data
..... creation S 1..1 dateTime Date attachment was first created
... context 1..1 BackboneElement Clinical context of document
.... facilityType 1..1 CodeableConcept Kind of facility where patient was seen

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. DocumentReference 0..* DocumentReference A reference to a document
... id Σ 0..1 id Logical id of this artifact
... meta SΣ 0..1 EsmdMeta Metadata about the resource
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ 0..1 id Version specific identifier
.... lastUpdated Σ 0..1 instant When the resource version last changed
.... source Σ 0..1 uri Identifies where the resource comes from
.... profile Σ 1..* canonical(StructureDefinition) Profiles this resource claims to conform to
Slice: Unordered, Open by value:$this
.... security SΣC 0..* Coding Security Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


inv-esmd-meta-security-01: esMD supports only V security code
.... tag Σ 0..* Coding Tags applied to this resource
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension S 5..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:esmdTransactionId S 1..* string ESMD Transaction ID
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-TransactionId
.... extension:organizationId S 1..1 string HIH Organization ID
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-OrganizationId
.... extension:reviewContractorOid S 1..1 code esMD Receiver OID
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-ReviewContractorOid
Binding: ESMD ReviewContractorOIDs ValueSet (required)
.... extension:npi S 0..1 string esMD Provider NPI
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-NPI
.... extension:requestType S 0..1 string Request Type
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-RequestType
.... extension:linesOfBusinessId S 1..1 code esMD support Lines of Business
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-LinesOfBusinessId
Binding: esMD Lines Of Business ValueSet (required)
.... extension:statusCode S 1..1 code Status Code
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-StatusCode
Binding: ESMD StatusCodes ValueSet (required): Codes used for esMD Custom Status Codes


... masterIdentifier Σ 0..1 Identifier Master Version Specific Identifier
... Slices for identifier Σ 1..* Identifier Other identifiers for the document
Slice: Unordered, Open by value:system
.... identifier:Esmd-Idn-UniqueId Σ 0..1 Identifier Other identifiers for the document
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

..... system Σ 1..1 uri The namespace for the identifier value
Fixed Value: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Idn-UniqueId
..... value Σ 0..1 string The value that is unique
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
.... identifier:Esmd-Idn-LetterId Σ 0..1 Identifier Other identifiers for the document
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

..... system Σ 1..1 uri The namespace for the identifier value
Fixed Value: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Idn-LetterId
..... value Σ 0..1 string The value that is unique
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... status ?!SΣ 1..1 code current | superseded | entered-in-error
Binding: DocumentReferenceStatus (required): The status of the document reference.


Required Pattern: current
... type SΣ 0..1 CodeableConcept Kind of document (LOINC if possible)
Binding: DocumentTypeValueSet (preferred): Precise type of clinical document.

... category SΣ 0..1 CodeableConcept Categorization of document
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.


... subject SΣ 0..1 Reference(Patient) Who/what is the subject of the document
... date SΣ 1..1 instant When this document reference was created
... author SΣ 0..* Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson) Who and/or what authored the document
... authenticator 0..1 Reference(Practitioner | PractitionerRole | Organization) Who/what authenticated the document
... custodian 0..1 Reference(Organization) Organization which maintains the document
... relatesTo SΣ 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 Σ 0..1 string Human-readable description
... securityLabel SΣ 1..* CodeableConcept Document security-tags
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


... content Σ 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 Σ 1..1 Attachment Where to access the document
..... id S 1..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... contentType SΣ 1..1 code Mime type of the content, with charset etc.
Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed.


Example General: text/plain; charset=UTF-8, image/png
..... language SΣ 0..1 code Human language of the content (BCP-47)
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding

Example General: en-AU
..... url SΣ 1..1 url Uri where the data can be found
Example General: http://www.acme.com/logo-small.png
..... size SΣ 1..1 unsignedInt Number of bytes of content (if url provided)
..... hash SΣ 1..1 base64Binary Hash of the data (sha-1, base64ed)
..... title SΣ 1..1 string Label to display in place of the data
Example General: Official Corporate Logo
..... creation SΣ 1..1 dateTime Date attachment was first created
.... format Σ 0..1 Coding Format/content rules for the document
Binding: DocumentReferenceFormatCodeSet (preferred): Document Format Codes.

... context Σ 1..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 0..* Reference(Encounter | EpisodeOfCare) 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 1..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

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
DocumentReference.meta.securityextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
DocumentReference.meta.tagexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
DocumentReference.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
DocumentReference.identifier:Esmd-Idn-UniqueId.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
DocumentReference.identifier:Esmd-Idn-UniqueId.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
DocumentReference.identifier:Esmd-Idn-LetterId.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
DocumentReference.identifier:Esmd-Idn-LetterId.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
DocumentReference.statusrequiredPattern: current
http://hl7.org/fhir/ValueSet/document-reference-status|4.0.1
from the FHIR Standard
DocumentReference.typepreferredDocumentTypeValueSet
http://hl7.org/fhir/ValueSet/c80-doc-typecodes
from the FHIR Standard
DocumentReference.categoryexampleDocumentClassValueSet
http://hl7.org/fhir/ValueSet/document-classcodes
from the FHIR Standard
DocumentReference.relatesTo.coderequiredDocumentRelationshipType
http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1
from the FHIR Standard
DocumentReference.securityLabelextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
DocumentReference.content.attachment.contentTyperequiredMime Types (a valid code from urn:ietf:bcp:13)
http://hl7.org/fhir/ValueSet/mimetypes|4.0.1
from the FHIR Standard
DocumentReference.content.attachment.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
DocumentReference.content.formatpreferredDocumentReferenceFormatCodeSet (a valid code from http://ihe.net/fhir/ValueSet/IHE.FormatCode.codesystem)
http://hl7.org/fhir/ValueSet/formatcodes
from the FHIR Standard
DocumentReference.context.eventexampleActCode
http://terminology.hl7.org/ValueSet/v3-ActCode
DocumentReference.context.facilityTypeexampleFacilityTypeCodeValueSet
http://hl7.org/fhir/ValueSet/c80-facilitycodes
from the FHIR Standard
DocumentReference.context.practiceSettingexamplePracticeSettingCodeValueSet
http://hl7.org/fhir/ValueSet/c80-practice-codes
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorDocumentReferenceIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorDocumentReferenceIf 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-4errorDocumentReferenceIf 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-5errorDocumentReferenceIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceDocumentReferenceA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
inv-esmd-meta-security-01errorDocumentReference.meta.securityesMD supports only V security code
: code.exists() implies (code = 'V' or code = 'HTEST')

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. DocumentReference 0..* DocumentReference A reference to a document
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
dom-6: A resource should have narrative for robust management
... meta SΣ 0..1 EsmdMeta Metadata about the resource
ele-1: All FHIR elements must have a @value or children
.... profile Σ 1..* canonical(StructureDefinition) Profiles this resource claims to conform to
Slice: Unordered, Open by value:$this
ele-1: All FHIR elements must have a @value or children
.... security SΣC 0..* Coding Security Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


ele-1: All FHIR elements must have a @value or children
inv-esmd-meta-security-01: esMD supports only V security code
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
ele-1: All FHIR elements must have a @value or children
... Slices for extension S 5..* Extension Extension
Slice: Unordered, Open by value:url
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... extension:esmdTransactionId S 1..* string ESMD Transaction ID
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-TransactionId
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... extension:organizationId S 1..1 string HIH Organization ID
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-OrganizationId
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... extension:reviewContractorOid S 1..1 code esMD Receiver OID
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-ReviewContractorOid
Binding: ESMD ReviewContractorOIDs ValueSet (required)
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... extension:npi S 0..1 string esMD Provider NPI
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-NPI
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... extension:requestType S 0..1 string Request Type
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-RequestType
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... extension:linesOfBusinessId S 1..1 code esMD support Lines of Business
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-LinesOfBusinessId
Binding: esMD Lines Of Business ValueSet (required)
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... extension:statusCode S 1..1 code Status Code
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-StatusCode
Binding: ESMD StatusCodes ValueSet (required): Codes used for esMD Custom Status Codes


ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... identifier:Esmd-Idn-UniqueId Σ 0..1 Identifier Other identifiers for the document
ele-1: All FHIR elements must have a @value or children
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


ele-1: All FHIR elements must have a @value or children
..... system Σ 1..1 uri The namespace for the identifier value
ele-1: All FHIR elements must have a @value or children
Fixed Value: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Idn-UniqueId
.... identifier:Esmd-Idn-LetterId Σ 0..1 Identifier Other identifiers for the document
ele-1: All FHIR elements must have a @value or children
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


ele-1: All FHIR elements must have a @value or children
..... system Σ 1..1 uri The namespace for the identifier value
ele-1: All FHIR elements must have a @value or children
Fixed Value: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Idn-LetterId
... status ?!SΣ 1..1 code current | superseded | entered-in-error
Binding: DocumentReferenceStatus (required): The status of the document reference.


ele-1: All FHIR elements must have a @value or children
Required Pattern: current
... type SΣ 0..1 CodeableConcept Kind of document (LOINC if possible)
Binding: DocumentTypeValueSet (preferred): Precise type of clinical document.


ele-1: All FHIR elements must have a @value or children
... category SΣ 0..1 CodeableConcept Categorization of document
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.


ele-1: All FHIR elements must have a @value or children
... subject SΣ 0..1 Reference(Patient) Who/what is the subject of the document
ele-1: All FHIR elements must have a @value or children
... date SΣ 1..1 instant When this document reference was created
ele-1: All FHIR elements must have a @value or children
... author SΣ 0..* Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson) Who and/or what authored the document
ele-1: All FHIR elements must have a @value or children
... relatesTo SΣ 0..* BackboneElement Relationships to other documents
ele-1: All FHIR elements must have a @value or children
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... code Σ 1..1 code replaces | transforms | signs | appends
Binding: DocumentRelationshipType (required): The type of relationship between documents.


ele-1: All FHIR elements must have a @value or children
.... target Σ 1..1 Reference(DocumentReference) Target of the relationship
ele-1: All FHIR elements must have a @value or children
... securityLabel SΣ 1..* CodeableConcept Document security-tags
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


ele-1: All FHIR elements must have a @value or children
... content Σ 1..* BackboneElement Document referenced
ele-1: All FHIR elements must have a @value or children
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... attachment Σ 1..1 Attachment Where to access the document
ele-1: All FHIR elements must have a @value or children
..... id S 1..1 string Unique id for inter-element referencing
..... contentType SΣ 1..1 code Mime type of the content, with charset etc.
Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed.


ele-1: All FHIR elements must have a @value or children
Example General: text/plain; charset=UTF-8, image/png
..... language SΣ 0..1 code Human language of the content (BCP-47)
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding

ele-1: All FHIR elements must have a @value or children
Example General: en-AU
..... url SΣ 1..1 url Uri where the data can be found
ele-1: All FHIR elements must have a @value or children
Example General: http://www.acme.com/logo-small.png
..... size SΣ 1..1 unsignedInt Number of bytes of content (if url provided)
ele-1: All FHIR elements must have a @value or children
..... hash SΣ 1..1 base64Binary Hash of the data (sha-1, base64ed)
ele-1: All FHIR elements must have a @value or children
..... title SΣ 1..1 string Label to display in place of the data
ele-1: All FHIR elements must have a @value or children
Example General: Official Corporate Logo
..... creation SΣ 1..1 dateTime Date attachment was first created
ele-1: All FHIR elements must have a @value or children
... context Σ 1..1 BackboneElement Clinical context of document
ele-1: All FHIR elements must have a @value or children
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... facilityType 1..1 CodeableConcept Kind of facility where patient was seen
Binding: FacilityTypeCodeValueSet (example): XDS Facility Type.


ele-1: All FHIR elements must have a @value or children

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
DocumentReference.meta.securityextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
DocumentReference.identifier:Esmd-Idn-UniqueId.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
DocumentReference.identifier:Esmd-Idn-LetterId.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
DocumentReference.statusrequiredPattern: current
http://hl7.org/fhir/ValueSet/document-reference-status|4.0.1
from the FHIR Standard
DocumentReference.typepreferredDocumentTypeValueSet
http://hl7.org/fhir/ValueSet/c80-doc-typecodes
from the FHIR Standard
DocumentReference.categoryexampleDocumentClassValueSet
http://hl7.org/fhir/ValueSet/document-classcodes
from the FHIR Standard
DocumentReference.relatesTo.coderequiredDocumentRelationshipType
http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1
from the FHIR Standard
DocumentReference.securityLabelextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
DocumentReference.content.attachment.contentTyperequiredMime Types (a valid code from urn:ietf:bcp:13)
http://hl7.org/fhir/ValueSet/mimetypes|4.0.1
from the FHIR Standard
DocumentReference.content.attachment.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
DocumentReference.context.facilityTypeexampleFacilityTypeCodeValueSet
http://hl7.org/fhir/ValueSet/c80-facilitycodes
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorDocumentReferenceIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorDocumentReferenceIf 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-4errorDocumentReferenceIf 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-5errorDocumentReferenceIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceDocumentReferenceA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
inv-esmd-meta-security-01errorDocumentReference.meta.securityesMD supports only V security code
: code.exists() implies (code = 'V' or code = 'HTEST')

Differential View

This structure is derived from DocumentReference

NameFlagsCard.TypeDescription & Constraintsdoco
.. DocumentReference DocumentReference
... meta S 0..1 EsmdMeta Metadata about the resource
.... security S 0..* Coding Security Labels applied to this resource
... Slices for extension S 5..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:esmdTransactionId S 1..* string ESMD Transaction ID
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-TransactionId
.... extension:organizationId S 1..1 string HIH Organization ID
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-OrganizationId
.... extension:reviewContractorOid S 1..1 code esMD Receiver OID
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-ReviewContractorOid
Binding: ESMD ReviewContractorOIDs ValueSet (required)
.... extension:npi S 0..1 string esMD Provider NPI
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-NPI
.... extension:requestType S 0..1 string Request Type
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-RequestType
.... extension:linesOfBusinessId S 1..1 code esMD support Lines of Business
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-LinesOfBusinessId
Binding: esMD Lines Of Business ValueSet (required)
.... extension:statusCode S 1..1 code Status Code
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-StatusCode
Binding: ESMD StatusCodes ValueSet (required): Codes used for esMD Custom Status Codes

... modifierExtension 0..0
.... identifier:Esmd-Idn-UniqueId 0..1 Identifier Other identifiers for the document
..... system 1..1 uri The namespace for the identifier value
Fixed Value: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Idn-UniqueId
.... identifier:Esmd-Idn-LetterId 0..1 Identifier Other identifiers for the document
..... system 1..1 uri The namespace for the identifier value
Fixed Value: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Idn-LetterId
... status S 1..1 code current | superseded | entered-in-error
Required Pattern: current
... docStatus 0..0
... type S 0..1 CodeableConcept Kind of document (LOINC if possible)
... category S 0..1 CodeableConcept Categorization of document
... subject S 0..1 Reference(Patient) Who/what is the subject of the document
... date S 1..1 instant When this document reference was created
... author S 0..* Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson) Who and/or what authored the document
... relatesTo S 0..* BackboneElement Relationships to other documents
... securityLabel S 1..* CodeableConcept Document security-tags
... content 1..* BackboneElement Document referenced
.... attachment
..... id S 1..1 string Unique id for inter-element referencing
..... contentType S 1..1 code Mime type of the content, with charset etc.
..... language S 0..1 code Human language of the content (BCP-47)
..... data 0..0
..... url S 1..1 url Uri where the data can be found
..... size S 1..1 unsignedInt Number of bytes of content (if url provided)
..... hash S 1..1 base64Binary Hash of the data (sha-1, base64ed)
..... title S 1..1 string Label to display in place of the data
..... creation S 1..1 dateTime Date attachment was first created
... context 1..1 BackboneElement Clinical context of document
.... facilityType 1..1 CodeableConcept Kind of facility where patient was seen

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. DocumentReference 0..* DocumentReference A reference to a document
... id Σ 0..1 id Logical id of this artifact
... meta SΣ 0..1 EsmdMeta Metadata about the resource
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... versionId Σ 0..1 id Version specific identifier
.... lastUpdated Σ 0..1 instant When the resource version last changed
.... source Σ 0..1 uri Identifies where the resource comes from
.... profile Σ 1..* canonical(StructureDefinition) Profiles this resource claims to conform to
Slice: Unordered, Open by value:$this
.... security SΣC 0..* Coding Security Labels applied to this resource
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


inv-esmd-meta-security-01: esMD supports only V security code
.... tag Σ 0..* Coding Tags applied to this resource
Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".


... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension S 5..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:esmdTransactionId S 1..* string ESMD Transaction ID
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-TransactionId
.... extension:organizationId S 1..1 string HIH Organization ID
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-OrganizationId
.... extension:reviewContractorOid S 1..1 code esMD Receiver OID
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-ReviewContractorOid
Binding: ESMD ReviewContractorOIDs ValueSet (required)
.... extension:npi S 0..1 string esMD Provider NPI
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-NPI
.... extension:requestType S 0..1 string Request Type
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-RequestType
.... extension:linesOfBusinessId S 1..1 code esMD support Lines of Business
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-LinesOfBusinessId
Binding: esMD Lines Of Business ValueSet (required)
.... extension:statusCode S 1..1 code Status Code
URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-StatusCode
Binding: ESMD StatusCodes ValueSet (required): Codes used for esMD Custom Status Codes


... masterIdentifier Σ 0..1 Identifier Master Version Specific Identifier
... Slices for identifier Σ 1..* Identifier Other identifiers for the document
Slice: Unordered, Open by value:system
.... identifier:Esmd-Idn-UniqueId Σ 0..1 Identifier Other identifiers for the document
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

..... system Σ 1..1 uri The namespace for the identifier value
Fixed Value: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Idn-UniqueId
..... value Σ 0..1 string The value that is unique
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
.... identifier:Esmd-Idn-LetterId Σ 0..1 Identifier Other identifiers for the document
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .

..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

..... system Σ 1..1 uri The namespace for the identifier value
Fixed Value: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Idn-LetterId
..... value Σ 0..1 string The value that is unique
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... status ?!SΣ 1..1 code current | superseded | entered-in-error
Binding: DocumentReferenceStatus (required): The status of the document reference.


Required Pattern: current
... type SΣ 0..1 CodeableConcept Kind of document (LOINC if possible)
Binding: DocumentTypeValueSet (preferred): Precise type of clinical document.

... category SΣ 0..1 CodeableConcept Categorization of document
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.


... subject SΣ 0..1 Reference(Patient) Who/what is the subject of the document
... date SΣ 1..1 instant When this document reference was created
... author SΣ 0..* Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson) Who and/or what authored the document
... authenticator 0..1 Reference(Practitioner | PractitionerRole | Organization) Who/what authenticated the document
... custodian 0..1 Reference(Organization) Organization which maintains the document
... relatesTo SΣ 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 Σ 0..1 string Human-readable description
... securityLabel SΣ 1..* CodeableConcept Document security-tags
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


... content Σ 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 Σ 1..1 Attachment Where to access the document
..... id S 1..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... contentType SΣ 1..1 code Mime type of the content, with charset etc.
Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed.


Example General: text/plain; charset=UTF-8, image/png
..... language SΣ 0..1 code Human language of the content (BCP-47)
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding

Example General: en-AU
..... url SΣ 1..1 url Uri where the data can be found
Example General: http://www.acme.com/logo-small.png
..... size SΣ 1..1 unsignedInt Number of bytes of content (if url provided)
..... hash SΣ 1..1 base64Binary Hash of the data (sha-1, base64ed)
..... title SΣ 1..1 string Label to display in place of the data
Example General: Official Corporate Logo
..... creation SΣ 1..1 dateTime Date attachment was first created
.... format Σ 0..1 Coding Format/content rules for the document
Binding: DocumentReferenceFormatCodeSet (preferred): Document Format Codes.

... context Σ 1..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 0..* Reference(Encounter | EpisodeOfCare) 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 1..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

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
DocumentReference.meta.securityextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
DocumentReference.meta.tagexampleCommonTags
http://hl7.org/fhir/ValueSet/common-tags
from the FHIR Standard
DocumentReference.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
DocumentReference.identifier:Esmd-Idn-UniqueId.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
DocumentReference.identifier:Esmd-Idn-UniqueId.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
DocumentReference.identifier:Esmd-Idn-LetterId.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
DocumentReference.identifier:Esmd-Idn-LetterId.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
DocumentReference.statusrequiredPattern: current
http://hl7.org/fhir/ValueSet/document-reference-status|4.0.1
from the FHIR Standard
DocumentReference.typepreferredDocumentTypeValueSet
http://hl7.org/fhir/ValueSet/c80-doc-typecodes
from the FHIR Standard
DocumentReference.categoryexampleDocumentClassValueSet
http://hl7.org/fhir/ValueSet/document-classcodes
from the FHIR Standard
DocumentReference.relatesTo.coderequiredDocumentRelationshipType
http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1
from the FHIR Standard
DocumentReference.securityLabelextensibleAll Security Labels
http://hl7.org/fhir/ValueSet/security-labels
from the FHIR Standard
DocumentReference.content.attachment.contentTyperequiredMime Types (a valid code from urn:ietf:bcp:13)
http://hl7.org/fhir/ValueSet/mimetypes|4.0.1
from the FHIR Standard
DocumentReference.content.attachment.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
DocumentReference.content.formatpreferredDocumentReferenceFormatCodeSet (a valid code from http://ihe.net/fhir/ValueSet/IHE.FormatCode.codesystem)
http://hl7.org/fhir/ValueSet/formatcodes
from the FHIR Standard
DocumentReference.context.eventexampleActCode
http://terminology.hl7.org/ValueSet/v3-ActCode
DocumentReference.context.facilityTypeexampleFacilityTypeCodeValueSet
http://hl7.org/fhir/ValueSet/c80-facilitycodes
from the FHIR Standard
DocumentReference.context.practiceSettingexamplePracticeSettingCodeValueSet
http://hl7.org/fhir/ValueSet/c80-practice-codes
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorDocumentReferenceIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorDocumentReferenceIf 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-4errorDocumentReferenceIf 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-5errorDocumentReferenceIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceDocumentReferenceA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
inv-esmd-meta-security-01errorDocumentReference.meta.securityesMD supports only V security code
: code.exists() implies (code = 'V' or code = 'HTEST')

 

Other representations of profile: CSV, Excel, Schematron