Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	ChLabComposition	CH ELM Composition: Laboratory Report
identifier		1..1	Identifier	Persistent, unique identifier for the document (UUID)
system		1..1	uri	The namespace for the identifier value Required Pattern: urn:ietf:rfc:3986
value	C	1..1	string	The value that is unique ch-elm-doc-identifier: The identifier must be an UUID. Example CH ELM: urn:uuid:d494503a-7bef-4551-853c-f3dced2c518f
status		1..1	code	preliminary | final | amended | entered-in-error Required Pattern: final
subject		1..1	Reference(CH ELM Patient)	Who and/or what the composition is about
author		1..1	Reference(CH ELM Organization: Author)	Who and/or what authored the composition
Slices for section		1..*	BackboneElement	Composition is broken into sections Slice: Unordered, Open by exists:$this.section, type:$this.entry.resolve(), pattern:$this.code
section:All Slices				Content/Rules for all slices
title		1..1	string	Label for section (e.g. for ToC)
code		1..1	ChElmCodeableConcept	Concept - reference to a terminology or just text
section:lab-no-subsections		1..1	BackboneElement	Composition is broken into sections
code		0..1	CodeableConcept	Classification of section (recommended) Binding: CH ELM Lab Study Types (required)
entry		1..1	Reference(CH ELM Observation Results: Laboratory)	A reference to data that supports this section
section		0..0
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Composition.section:lab-no-subsections.code	required	ChElmLabStudyTypes

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-elm-doc-identifier	error	Composition.identifier.value	The identifier must be an UUID. : startsWith('urn:uuid:')

Name	Flags	Card.	Type	Description & Constraints
Composition	C	0..*	ChLabComposition	CH ELM Composition: Laboratory Report
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	1..1	Identifier	Persistent, unique identifier for the document (UUID)
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Required Pattern: urn:ietf:rfc:3986
value	ΣC	1..1	string	The value that is unique ch-elm-doc-identifier: The identifier must be an UUID. Example General: 123456 Example CH ELM: urn:uuid:d494503a-7bef-4551-853c-f3dced2c518f
status	?!Σ	1..1	code	preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): The workflow/clinical status of the composition. Required Pattern: final
type	Σ	1..1	CodeableConcept	Kind of composition (LOINC if possible) Binding: FHIRDocumentTypeCodes (preferred): Type of a composition. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 11502-2
subject	Σ	1..1	Reference(CH ELM Patient)	Who and/or what the composition is about
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
date	Σ	1..1	dateTime	Composition editing time
author	Σ	1..1	Reference(CH ELM Organization: Author)	Who and/or what authored the composition
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
title	Σ	1..1	string	Human Readable name/title
Slices for section	C	1..*	BackboneElement	Composition is broken into sections Slice: Unordered, Open by exists:$this.section, type:$this.entry.resolve(), pattern:$this.code
section:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title		1..1	string	Label for section (e.g. for ToC)
code		1..1	ChElmCodeableConcept	Concept - reference to a terminology or just text Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
section:lab-no-subsections	C	1..1	BackboneElement	Composition is broken into sections
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		0..1	CodeableConcept	Classification of section (recommended) Binding: CH ELM Lab Study Types (required)
entry	C	1..1	Reference(CH ELM Observation Results: Laboratory)	A reference to data that supports this section
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Composition.identifier.use	required	IdentifierUse
Composition.status	required	Pattern: final
Composition.type	preferred	Pattern: LOINC code 11502-2
Composition.section.code	example	DocumentSectionCodes
Composition.section:lab-no-subsections.code	required	ChElmLabStudyTypes

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-elm-doc-identifier	error	Composition.identifier.value	The identifier must be an UUID. : startsWith('urn:uuid:')
ch-lab-comp1	warning	Composition	The resource should be conform to the corresponding EU LAB profile : conformsTo('http://hl7.eu/fhir/laboratory/StructureDefinition/Composition-eu-lab')
cmp-1	error	Composition.section, Composition.section:lab-no-subsections	A section must contain at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists()
cmp-2	error	Composition.section, Composition.section:lab-no-subsections	A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty()
dom-2	error	Composition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Composition	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Composition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Composition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Composition	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Name	Flags	Card.	Type	Description & Constraints
Composition	C	0..*	ChLabComposition	CH ELM Composition: Laboratory Report
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	1..1	Identifier	Persistent, unique identifier for the document (UUID)
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 Required Pattern: urn:ietf:rfc:3986
value	ΣC	1..1	string	The value that is unique ch-elm-doc-identifier: The identifier must be an UUID. Example General: 123456 Example CH ELM: urn:uuid:d494503a-7bef-4551-853c-f3dced2c518f
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	?!Σ	1..1	code	preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): The workflow/clinical status of the composition. Required Pattern: final
type	Σ	1..1	CodeableConcept	Kind of composition (LOINC if possible) Binding: FHIRDocumentTypeCodes (preferred): Type of a composition. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 11502-2
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
category	Σ	0..*	CodeableConcept	Categorization of Composition Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 4241000179101
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subject	Σ	1..1	Reference(CH ELM Patient)	Who and/or what the composition is about
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
encounter	Σ	0..1	Reference(CH Core Encounter)	Context of the Composition
date	Σ	1..1	dateTime	Composition editing time
author	Σ	1..1	Reference(CH ELM Organization: Author)	Who and/or what authored the composition
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
title	Σ	1..1	string	Human Readable name/title
confidentiality	Σ	0..1	code	As defined by affinity domain Binding: v3.ConfidentialityClassification (2014-03-26) (required): Codes specifying the level of confidentiality of the composition.
attester		0..*	BackboneElement	Attests to accuracy of composition
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
mode		1..1	code	personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition.
time		0..1	dateTime	When the composition was attested
party		0..1	Reference(CH Core Patient | RelatedPerson | CH Core Practitioner | CH Core PractitionerRole | CH Core Organization)	Who attested the composition
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
custodian	Σ	0..1	Reference(CH Core Organization)	Organization which maintains the composition
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
relatesTo		0..*	BackboneElement	Relationships to other compositions/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		1..1	code	replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target[x]		1..1		Target of the relationship
targetIdentifier			Identifier
targetReference			Reference(CH Core Composition)
event	Σ	0..*	BackboneElement	The clinical service(s) being documented
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	0..*	CodeableConcept	Code(s) that apply to the event being documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.
period	Σ	0..1	Period	The period covered by the documentation
detail	Σ	0..*	Reference(Resource)	The event(s) being documented
Slices for section	C	1..*	BackboneElement	Composition is broken into sections Slice: Unordered, Open by exists:$this.section, type:$this.entry.resolve(), pattern:$this.code
section:All Slices				Content/Rules for all slices
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
title		1..1	string	Label for section (e.g. for ToC)
code		1..1	ChElmCodeableConcept	Concept - reference to a terminology or just text Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
author		0..*	Reference(CH Core Practitioner | CH Core PractitionerRole | Device | CH Core Patient | RelatedPerson | CH Core Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Resource)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:lab-no-subsections	C	1..1	BackboneElement	Composition is broken into sections
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
title		0..1	string	Label for section (e.g. for ToC)
code		0..1	CodeableConcept	Classification of section (recommended) Binding: CH ELM Lab Study Types (required)
author		0..*	Reference(CH Core Practitioner | CH Core PractitionerRole | Device | CH Core Patient | RelatedPerson | CH Core Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	1..1	Reference(CH ELM Observation Results: Laboratory)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Composition.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Composition.identifier.use	required	IdentifierUse
Composition.identifier.type	extensible	Identifier Type Codes
Composition.status	required	Pattern: final
Composition.type	preferred	Pattern: LOINC code 11502-2
Composition.category	example	Pattern: SNOMED CT code 4241000179101
Composition.subject.type	extensible	ResourceType
Composition.author.type	extensible	ResourceType
Composition.confidentiality	required	v3.ConfidentialityClassification
Composition.attester.mode	required	CompositionAttestationMode
Composition.attester.party.type	extensible	ResourceType
Composition.custodian.type	extensible	ResourceType
Composition.relatesTo.code	required	DocumentRelationshipType
Composition.event.code	example	ActCode
Composition.section.code	example	DocumentSectionCodes
Composition.section.mode	required	ListMode
Composition.section.orderedBy	preferred	ListOrderCodes
Composition.section.emptyReason	preferred	ListEmptyReasons
Composition.section:lab-no-subsections.code	required	ChElmLabStudyTypes
Composition.section:lab-no-subsections.mode	required	ListMode
Composition.section:lab-no-subsections.orderedBy	preferred	ListOrderCodes
Composition.section:lab-no-subsections.emptyReason	preferred	ListEmptyReasons

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-elm-doc-identifier	error	Composition.identifier.value	The identifier must be an UUID. : startsWith('urn:uuid:')
ch-lab-comp1	warning	Composition	The resource should be conform to the corresponding EU LAB profile : conformsTo('http://hl7.eu/fhir/laboratory/StructureDefinition/Composition-eu-lab')
cmp-1	error	Composition.section, Composition.section:lab-no-subsections	A section must contain at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists()
cmp-2	error	Composition.section, Composition.section:lab-no-subsections	A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty()
dom-2	error	Composition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Composition	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Composition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Composition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Composition	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Summary

Mandatory: 9 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

• CH ELM Patient (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-patient)
• CH ELM Organization: Author (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-organization-author)
• CH ELM CodeableConcept (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-codeableconcept)
• CH ELM Observation Results: Laboratory (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-observation-results-laboratory)

Slices

This structure defines the following Slices:

• The element Composition.section is sliced based on the values of exists:$this.section, type:$this.entry.resolve(), pattern:$this.code

Name	Flags	Card.	Type	Description & Constraints
Composition		0..*	ChLabComposition	CH ELM Composition: Laboratory Report
identifier		1..1	Identifier	Persistent, unique identifier for the document (UUID)
system		1..1	uri	The namespace for the identifier value Required Pattern: urn:ietf:rfc:3986
value	C	1..1	string	The value that is unique ch-elm-doc-identifier: The identifier must be an UUID. Example CH ELM: urn:uuid:d494503a-7bef-4551-853c-f3dced2c518f
status		1..1	code	preliminary | final | amended | entered-in-error Required Pattern: final
subject		1..1	Reference(CH ELM Patient)	Who and/or what the composition is about
author		1..1	Reference(CH ELM Organization: Author)	Who and/or what authored the composition
Slices for section		1..*	BackboneElement	Composition is broken into sections Slice: Unordered, Open by exists:$this.section, type:$this.entry.resolve(), pattern:$this.code
section:All Slices				Content/Rules for all slices
title		1..1	string	Label for section (e.g. for ToC)
code		1..1	ChElmCodeableConcept	Concept - reference to a terminology or just text
section:lab-no-subsections		1..1	BackboneElement	Composition is broken into sections
code		0..1	CodeableConcept	Classification of section (recommended) Binding: CH ELM Lab Study Types (required)
entry		1..1	Reference(CH ELM Observation Results: Laboratory)	A reference to data that supports this section
section		0..0
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Composition.section:lab-no-subsections.code	required	ChElmLabStudyTypes

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-elm-doc-identifier	error	Composition.identifier.value	The identifier must be an UUID. : startsWith('urn:uuid:')

Name	Flags	Card.	Type	Description & Constraints
Composition	C	0..*	ChLabComposition	CH ELM Composition: Laboratory Report
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	1..1	Identifier	Persistent, unique identifier for the document (UUID)
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Required Pattern: urn:ietf:rfc:3986
value	ΣC	1..1	string	The value that is unique ch-elm-doc-identifier: The identifier must be an UUID. Example General: 123456 Example CH ELM: urn:uuid:d494503a-7bef-4551-853c-f3dced2c518f
status	?!Σ	1..1	code	preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): The workflow/clinical status of the composition. Required Pattern: final
type	Σ	1..1	CodeableConcept	Kind of composition (LOINC if possible) Binding: FHIRDocumentTypeCodes (preferred): Type of a composition. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 11502-2
subject	Σ	1..1	Reference(CH ELM Patient)	Who and/or what the composition is about
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
date	Σ	1..1	dateTime	Composition editing time
author	Σ	1..1	Reference(CH ELM Organization: Author)	Who and/or what authored the composition
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
title	Σ	1..1	string	Human Readable name/title
Slices for section	C	1..*	BackboneElement	Composition is broken into sections Slice: Unordered, Open by exists:$this.section, type:$this.entry.resolve(), pattern:$this.code
section:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title		1..1	string	Label for section (e.g. for ToC)
code		1..1	ChElmCodeableConcept	Concept - reference to a terminology or just text Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
section:lab-no-subsections	C	1..1	BackboneElement	Composition is broken into sections
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		0..1	CodeableConcept	Classification of section (recommended) Binding: CH ELM Lab Study Types (required)
entry	C	1..1	Reference(CH ELM Observation Results: Laboratory)	A reference to data that supports this section
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Composition.identifier.use	required	IdentifierUse
Composition.status	required	Pattern: final
Composition.type	preferred	Pattern: LOINC code 11502-2
Composition.section.code	example	DocumentSectionCodes
Composition.section:lab-no-subsections.code	required	ChElmLabStudyTypes

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-elm-doc-identifier	error	Composition.identifier.value	The identifier must be an UUID. : startsWith('urn:uuid:')
ch-lab-comp1	warning	Composition	The resource should be conform to the corresponding EU LAB profile : conformsTo('http://hl7.eu/fhir/laboratory/StructureDefinition/Composition-eu-lab')
cmp-1	error	Composition.section, Composition.section:lab-no-subsections	A section must contain at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists()
cmp-2	error	Composition.section, Composition.section:lab-no-subsections	A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty()
dom-2	error	Composition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Composition	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Composition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Composition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Composition	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Name	Flags	Card.	Type	Description & Constraints
Composition	C	0..*	ChLabComposition	CH ELM Composition: Laboratory Report
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	1..1	Identifier	Persistent, unique identifier for the document (UUID)
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 Required Pattern: urn:ietf:rfc:3986
value	ΣC	1..1	string	The value that is unique ch-elm-doc-identifier: The identifier must be an UUID. Example General: 123456 Example CH ELM: urn:uuid:d494503a-7bef-4551-853c-f3dced2c518f
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	?!Σ	1..1	code	preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): The workflow/clinical status of the composition. Required Pattern: final
type	Σ	1..1	CodeableConcept	Kind of composition (LOINC if possible) Binding: FHIRDocumentTypeCodes (preferred): Type of a composition. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 11502-2
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
category	Σ	0..*	CodeableConcept	Categorization of Composition Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 4241000179101
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subject	Σ	1..1	Reference(CH ELM Patient)	Who and/or what the composition is about
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
encounter	Σ	0..1	Reference(CH Core Encounter)	Context of the Composition
date	Σ	1..1	dateTime	Composition editing time
author	Σ	1..1	Reference(CH ELM Organization: Author)	Who and/or what authored the composition
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
title	Σ	1..1	string	Human Readable name/title
confidentiality	Σ	0..1	code	As defined by affinity domain Binding: v3.ConfidentialityClassification (2014-03-26) (required): Codes specifying the level of confidentiality of the composition.
attester		0..*	BackboneElement	Attests to accuracy of composition
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
mode		1..1	code	personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition.
time		0..1	dateTime	When the composition was attested
party		0..1	Reference(CH Core Patient | RelatedPerson | CH Core Practitioner | CH Core PractitionerRole | CH Core Organization)	Who attested the composition
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
custodian	Σ	0..1	Reference(CH Core Organization)	Organization which maintains the composition
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	1..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
relatesTo		0..*	BackboneElement	Relationships to other compositions/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		1..1	code	replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target[x]		1..1		Target of the relationship
targetIdentifier			Identifier
targetReference			Reference(CH Core Composition)
event	Σ	0..*	BackboneElement	The clinical service(s) being documented
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	0..*	CodeableConcept	Code(s) that apply to the event being documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.
period	Σ	0..1	Period	The period covered by the documentation
detail	Σ	0..*	Reference(Resource)	The event(s) being documented
Slices for section	C	1..*	BackboneElement	Composition is broken into sections Slice: Unordered, Open by exists:$this.section, type:$this.entry.resolve(), pattern:$this.code
section:All Slices				Content/Rules for all slices
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
title		1..1	string	Label for section (e.g. for ToC)
code		1..1	ChElmCodeableConcept	Concept - reference to a terminology or just text Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
author		0..*	Reference(CH Core Practitioner | CH Core PractitionerRole | Device | CH Core Patient | RelatedPerson | CH Core Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	0..*	Reference(Resource)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
section:lab-no-subsections	C	1..1	BackboneElement	Composition is broken into sections
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
title		0..1	string	Label for section (e.g. for ToC)
code		0..1	CodeableConcept	Classification of section (recommended) Binding: CH ELM Lab Study Types (required)
author		0..*	Reference(CH Core Practitioner | CH Core PractitionerRole | Device | CH Core Patient | RelatedPerson | CH Core Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	C	1..1	Reference(CH ELM Observation Results: Laboratory)	A reference to data that supports this section
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Composition.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Composition.identifier.use	required	IdentifierUse
Composition.identifier.type	extensible	Identifier Type Codes
Composition.status	required	Pattern: final
Composition.type	preferred	Pattern: LOINC code 11502-2
Composition.category	example	Pattern: SNOMED CT code 4241000179101
Composition.subject.type	extensible	ResourceType
Composition.author.type	extensible	ResourceType
Composition.confidentiality	required	v3.ConfidentialityClassification
Composition.attester.mode	required	CompositionAttestationMode
Composition.attester.party.type	extensible	ResourceType
Composition.custodian.type	extensible	ResourceType
Composition.relatesTo.code	required	DocumentRelationshipType
Composition.event.code	example	ActCode
Composition.section.code	example	DocumentSectionCodes
Composition.section.mode	required	ListMode
Composition.section.orderedBy	preferred	ListOrderCodes
Composition.section.emptyReason	preferred	ListEmptyReasons
Composition.section:lab-no-subsections.code	required	ChElmLabStudyTypes
Composition.section:lab-no-subsections.mode	required	ListMode
Composition.section:lab-no-subsections.orderedBy	preferred	ListOrderCodes
Composition.section:lab-no-subsections.emptyReason	preferred	ListEmptyReasons

Constraints

Id	Grade	Path(s)	Details	Requirements
ch-elm-doc-identifier	error	Composition.identifier.value	The identifier must be an UUID. : startsWith('urn:uuid:')
ch-lab-comp1	warning	Composition	The resource should be conform to the corresponding EU LAB profile : conformsTo('http://hl7.eu/fhir/laboratory/StructureDefinition/Composition-eu-lab')
cmp-1	error	Composition.section, Composition.section:lab-no-subsections	A section must contain at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists()
cmp-2	error	Composition.section, Composition.section:lab-no-subsections	A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty()
dom-2	error	Composition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Composition	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Composition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Composition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Composition	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Summary

Mandatory: 9 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

• CH ELM Patient (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-patient)
• CH ELM Organization: Author (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-organization-author)
• CH ELM CodeableConcept (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-codeableconcept)
• CH ELM Observation Results: Laboratory (http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-observation-results-laboratory)

Slices

This structure defines the following Slices:

• The element Composition.section is sliced based on the values of exists:$this.section, type:$this.entry.resolve(), pattern:$this.code