CH ELM (R4)
1.1.1 - draft Switzerland flag

This page is part of the Observations of notifiable communicable infectious diseases (v1.1.1: STU 1 Draft) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Resource Profile: DocumentReference for sending the report with strict validation

Official URL: http://fhir.ch/ig/ch-elm/StructureDefinition/PublishDocumentReferenceStrict Version: 1.1.1
Active as of 2024-02-27 Computable Name: PublishDocumentReferenceStrict

Copyright/Legal: CC0-1.0

A profile on the DocumentReference resource with publication constraints:

  • must be status current
  • must have an identifier
  • uses attachment.url to carry the document as a contained resource
  • strict validation according to http://fhir.ch/ig/ch-elm/StructureDefinition/ch-elm-document-strict

Usage:

  • This Resource Profile is not used by any profiles in this Implementation Guide

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraintsdoco
.. DocumentReference 0..*PublishDocumentReferenceA reference to a document
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... Slices for contained 1..*ResourceContained, inline Resources
Slice: Unordered, Open by profile:$this
.... contained:document SC1..1ChElmDocumentStrictCH ELM Document: Laboratory Report
... identifier Σ1..1IdentifierOther identifiers for the document
... date SΣ0..1instantWhen this document reference was created
... relatesTo SΣ0..*BackboneElementRelationships to other documents
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code Σ1..1codereplaces | transforms | signs | appends
Binding: DocumentRelationshipType (required): The type of relationship between documents.

.... target Σ1..1Reference(DocumentReference)Target of the relationship
... securityLabel SΣ0..*CodeableConceptDocument security-tags
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


... content Σ1..1BackboneElementDocument referenced
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... attachment ΣC1..1AttachmentWhere to access the document
..... language SΣ0..1codeHuman language of the content (BCP-47)
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding

Example General: en-AU
..... url Σ1..1urlThe document is referenced by this url, contained in the DocumentReference
Example General: http://www.acme.com/logo-small.png
..... creation SΣ0..1dateTimeDate attachment was first created

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
DocumentReference.statusrequiredPattern: current
http://hl7.org/fhir/ValueSet/document-reference-status|4.0.1
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.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
bdl-1errorDocumentReference.contained:documenttotal only when a search or history
: total.empty() or (type = 'searchset') or (type = 'history')
bdl-2errorDocumentReference.contained:documententry.search only when a search
: entry.search.empty() or (type = 'searchset')
bdl-3errorDocumentReference.contained:documententry.request mandatory for batch/transaction/history, otherwise prohibited
: entry.all(request.exists() = (%resource.type = 'batch' or %resource.type = 'transaction' or %resource.type = 'history'))
bdl-4errorDocumentReference.contained:documententry.response mandatory for batch-response/transaction-response/history, otherwise prohibited
: entry.all(response.exists() = (%resource.type = 'batch-response' or %resource.type = 'transaction-response' or %resource.type = 'history'))
bdl-7errorDocumentReference.contained:documentFullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles)
: (type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&resource.meta.versionId).isDistinct()
bdl-9errorDocumentReference.contained:documentA document must have an identifier with a system and a value
: type = 'document' implies (identifier.system.exists() and identifier.value.exists())
bdl-10errorDocumentReference.contained:documentA document must have a date
: type = 'document' implies (timestamp.hasValue())
bdl-11errorDocumentReference.contained:documentA document must have a Composition as the first resource
: type = 'document' implies entry.first().resource.is(Composition)
bdl-12errorDocumentReference.contained:documentA message must have a MessageHeader as the first resource
: type = 'message' implies entry.first().resource.is(MessageHeader)
ch-elm-leading-codewarningDocumentReference.contained:documentThe ServiceRequest.code and the Observation.code are in general equal.
: entry.resource.ofType(ServiceRequest).code = entry.resource.ofType(Observation).code
ch-elm-resolveableurlerrorDocumentReference.content.attachmentMust have a resolvable URL.
: url.exists() and url.resolve()
ch-lab-bdl1warningDocumentReference.contained:documentThe resource should be conform to the corresponding EU LAB profile
: conformsTo('http://hl7.eu/fhir/laboratory/StructureDefinition/Bundle-eu-lab')
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()
NameFlagsCard.TypeDescription & Constraintsdoco
.. DocumentReference 0..*PublishDocumentReferenceA reference to a document
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... text 0..1NarrativeText summary of the resource, for human interpretation
... Slices for contained 1..*ResourceContained, inline Resources
Slice: Unordered, Open by profile:$this
.... contained:document SC1..1ChElmDocumentStrictCH ELM Document: Laboratory Report
... extension 0..*ExtensionAdditional content defined by implementations
... masterIdentifier Σ0..1IdentifierMaster Version Specific Identifier
... identifier Σ1..1IdentifierOther identifiers for the document
... status ?!Σ1..1codecurrent | superseded | entered-in-error
Binding: DocumentReferenceStatus (required): The status of the document reference.


Required Pattern: current
... type Σ0..1CodeableConceptKind of document (LOINC if possible)
Binding: DocumentTypeValueSet (preferred): Precise type of clinical document.

... category Σ0..*CodeableConceptCategorization of document
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.


... subject Σ0..1Reference(Patient | Practitioner | Group | Device)Who/what is the subject of the document
... date SΣ0..1instantWhen this document reference was created
... author Σ0..*Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson)Who and/or what authored the document
... authenticator 0..1Reference(Practitioner | PractitionerRole | Organization)Who/what authenticated the document
... custodian 0..1Reference(Organization)Organization which maintains the document
... relatesTo SΣ0..*BackboneElementRelationships to other documents
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code Σ1..1codereplaces | transforms | signs | appends
Binding: DocumentRelationshipType (required): The type of relationship between documents.

.... target Σ1..1Reference(DocumentReference)Target of the relationship
... description Σ0..1stringHuman-readable description
... securityLabel SΣ0..*CodeableConceptDocument security-tags
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


... content Σ1..1BackboneElementDocument referenced
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... attachment ΣC1..1AttachmentWhere to access the document
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... contentType Σ0..1codeMime 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 SΣ0..1codeHuman language of the content (BCP-47)
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding

Example General: en-AU
..... data 0..1base64BinaryData inline, base64ed
..... url Σ1..1urlThe document is referenced by this url, contained in the DocumentReference
Example General: http://www.acme.com/logo-small.png
..... size Σ0..1unsignedIntNumber of bytes of content (if url provided)
..... hash Σ0..1base64BinaryHash of the data (sha-1, base64ed)
..... title Σ0..1stringLabel to display in place of the data
Example General: Official Corporate Logo
..... creation SΣ0..1dateTimeDate attachment was first created
.... format Σ0..1CodingFormat/content rules for the document
Binding: DocumentReferenceFormatCodeSet (preferred): Document Format Codes.

... context Σ0..1BackboneElementClinical context of document
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... encounter 0..*Reference(Encounter | EpisodeOfCare)Context of the document content
.... event 0..*CodeableConceptMain clinical acts documented
Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.


.... period Σ0..1PeriodTime of service that is being documented
.... facilityType 0..1CodeableConceptKind of facility where patient was seen
Binding: FacilityTypeCodeValueSet (example): XDS Facility Type.

.... practiceSetting 0..1CodeableConceptAdditional 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..1Reference(Patient)Patient demographics from source
.... related 0..*Reference(Resource)Related identifiers or resources

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
DocumentReference.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
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
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
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
bdl-1errorDocumentReference.contained:documenttotal only when a search or history
: total.empty() or (type = 'searchset') or (type = 'history')
bdl-2errorDocumentReference.contained:documententry.search only when a search
: entry.search.empty() or (type = 'searchset')
bdl-3errorDocumentReference.contained:documententry.request mandatory for batch/transaction/history, otherwise prohibited
: entry.all(request.exists() = (%resource.type = 'batch' or %resource.type = 'transaction' or %resource.type = 'history'))
bdl-4errorDocumentReference.contained:documententry.response mandatory for batch-response/transaction-response/history, otherwise prohibited
: entry.all(response.exists() = (%resource.type = 'batch-response' or %resource.type = 'transaction-response' or %resource.type = 'history'))
bdl-7errorDocumentReference.contained:documentFullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles)
: (type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&resource.meta.versionId).isDistinct()
bdl-9errorDocumentReference.contained:documentA document must have an identifier with a system and a value
: type = 'document' implies (identifier.system.exists() and identifier.value.exists())
bdl-10errorDocumentReference.contained:documentA document must have a date
: type = 'document' implies (timestamp.hasValue())
bdl-11errorDocumentReference.contained:documentA document must have a Composition as the first resource
: type = 'document' implies entry.first().resource.is(Composition)
bdl-12errorDocumentReference.contained:documentA message must have a MessageHeader as the first resource
: type = 'message' implies entry.first().resource.is(MessageHeader)
ch-elm-leading-codewarningDocumentReference.contained:documentThe ServiceRequest.code and the Observation.code are in general equal.
: entry.resource.ofType(ServiceRequest).code = entry.resource.ofType(Observation).code
ch-elm-resolveableurlerrorDocumentReference.content.attachmentMust have a resolvable URL.
: url.exists() and url.resolve()
ch-lab-bdl1warningDocumentReference.contained:documentThe resource should be conform to the corresponding EU LAB profile
: conformsTo('http://hl7.eu/fhir/laboratory/StructureDefinition/Bundle-eu-lab')
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()

This structure is derived from PublishDocumentReference

Differential View

This structure is derived from PublishDocumentReference

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. DocumentReference 0..*PublishDocumentReferenceA reference to a document
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... Slices for contained 1..*ResourceContained, inline Resources
Slice: Unordered, Open by profile:$this
.... contained:document SC1..1ChElmDocumentStrictCH ELM Document: Laboratory Report
... identifier Σ1..1IdentifierOther identifiers for the document
... date SΣ0..1instantWhen this document reference was created
... relatesTo SΣ0..*BackboneElementRelationships to other documents
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code Σ1..1codereplaces | transforms | signs | appends
Binding: DocumentRelationshipType (required): The type of relationship between documents.

.... target Σ1..1Reference(DocumentReference)Target of the relationship
... securityLabel SΣ0..*CodeableConceptDocument security-tags
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


... content Σ1..1BackboneElementDocument referenced
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... attachment ΣC1..1AttachmentWhere to access the document
..... language SΣ0..1codeHuman language of the content (BCP-47)
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding

Example General: en-AU
..... url Σ1..1urlThe document is referenced by this url, contained in the DocumentReference
Example General: http://www.acme.com/logo-small.png
..... creation SΣ0..1dateTimeDate attachment was first created

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
DocumentReference.statusrequiredPattern: current
http://hl7.org/fhir/ValueSet/document-reference-status|4.0.1
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.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
bdl-1errorDocumentReference.contained:documenttotal only when a search or history
: total.empty() or (type = 'searchset') or (type = 'history')
bdl-2errorDocumentReference.contained:documententry.search only when a search
: entry.search.empty() or (type = 'searchset')
bdl-3errorDocumentReference.contained:documententry.request mandatory for batch/transaction/history, otherwise prohibited
: entry.all(request.exists() = (%resource.type = 'batch' or %resource.type = 'transaction' or %resource.type = 'history'))
bdl-4errorDocumentReference.contained:documententry.response mandatory for batch-response/transaction-response/history, otherwise prohibited
: entry.all(response.exists() = (%resource.type = 'batch-response' or %resource.type = 'transaction-response' or %resource.type = 'history'))
bdl-7errorDocumentReference.contained:documentFullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles)
: (type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&resource.meta.versionId).isDistinct()
bdl-9errorDocumentReference.contained:documentA document must have an identifier with a system and a value
: type = 'document' implies (identifier.system.exists() and identifier.value.exists())
bdl-10errorDocumentReference.contained:documentA document must have a date
: type = 'document' implies (timestamp.hasValue())
bdl-11errorDocumentReference.contained:documentA document must have a Composition as the first resource
: type = 'document' implies entry.first().resource.is(Composition)
bdl-12errorDocumentReference.contained:documentA message must have a MessageHeader as the first resource
: type = 'message' implies entry.first().resource.is(MessageHeader)
ch-elm-leading-codewarningDocumentReference.contained:documentThe ServiceRequest.code and the Observation.code are in general equal.
: entry.resource.ofType(ServiceRequest).code = entry.resource.ofType(Observation).code
ch-elm-resolveableurlerrorDocumentReference.content.attachmentMust have a resolvable URL.
: url.exists() and url.resolve()
ch-lab-bdl1warningDocumentReference.contained:documentThe resource should be conform to the corresponding EU LAB profile
: conformsTo('http://hl7.eu/fhir/laboratory/StructureDefinition/Bundle-eu-lab')
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()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. DocumentReference 0..*PublishDocumentReferenceA reference to a document
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... text 0..1NarrativeText summary of the resource, for human interpretation
... Slices for contained 1..*ResourceContained, inline Resources
Slice: Unordered, Open by profile:$this
.... contained:document SC1..1ChElmDocumentStrictCH ELM Document: Laboratory Report
... extension 0..*ExtensionAdditional content defined by implementations
... masterIdentifier Σ0..1IdentifierMaster Version Specific Identifier
... identifier Σ1..1IdentifierOther identifiers for the document
... status ?!Σ1..1codecurrent | superseded | entered-in-error
Binding: DocumentReferenceStatus (required): The status of the document reference.


Required Pattern: current
... type Σ0..1CodeableConceptKind of document (LOINC if possible)
Binding: DocumentTypeValueSet (preferred): Precise type of clinical document.

... category Σ0..*CodeableConceptCategorization of document
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.


... subject Σ0..1Reference(Patient | Practitioner | Group | Device)Who/what is the subject of the document
... date SΣ0..1instantWhen this document reference was created
... author Σ0..*Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson)Who and/or what authored the document
... authenticator 0..1Reference(Practitioner | PractitionerRole | Organization)Who/what authenticated the document
... custodian 0..1Reference(Organization)Organization which maintains the document
... relatesTo SΣ0..*BackboneElementRelationships to other documents
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code Σ1..1codereplaces | transforms | signs | appends
Binding: DocumentRelationshipType (required): The type of relationship between documents.

.... target Σ1..1Reference(DocumentReference)Target of the relationship
... description Σ0..1stringHuman-readable description
... securityLabel SΣ0..*CodeableConceptDocument security-tags
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.


... content Σ1..1BackboneElementDocument referenced
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... attachment ΣC1..1AttachmentWhere to access the document
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... contentType Σ0..1codeMime 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 SΣ0..1codeHuman language of the content (BCP-47)
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding

Example General: en-AU
..... data 0..1base64BinaryData inline, base64ed
..... url Σ1..1urlThe document is referenced by this url, contained in the DocumentReference
Example General: http://www.acme.com/logo-small.png
..... size Σ0..1unsignedIntNumber of bytes of content (if url provided)
..... hash Σ0..1base64BinaryHash of the data (sha-1, base64ed)
..... title Σ0..1stringLabel to display in place of the data
Example General: Official Corporate Logo
..... creation SΣ0..1dateTimeDate attachment was first created
.... format Σ0..1CodingFormat/content rules for the document
Binding: DocumentReferenceFormatCodeSet (preferred): Document Format Codes.

... context Σ0..1BackboneElementClinical context of document
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... encounter 0..*Reference(Encounter | EpisodeOfCare)Context of the document content
.... event 0..*CodeableConceptMain clinical acts documented
Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.


.... period Σ0..1PeriodTime of service that is being documented
.... facilityType 0..1CodeableConceptKind of facility where patient was seen
Binding: FacilityTypeCodeValueSet (example): XDS Facility Type.

.... practiceSetting 0..1CodeableConceptAdditional 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..1Reference(Patient)Patient demographics from source
.... related 0..*Reference(Resource)Related identifiers or resources

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
DocumentReference.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
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
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
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
bdl-1errorDocumentReference.contained:documenttotal only when a search or history
: total.empty() or (type = 'searchset') or (type = 'history')
bdl-2errorDocumentReference.contained:documententry.search only when a search
: entry.search.empty() or (type = 'searchset')
bdl-3errorDocumentReference.contained:documententry.request mandatory for batch/transaction/history, otherwise prohibited
: entry.all(request.exists() = (%resource.type = 'batch' or %resource.type = 'transaction' or %resource.type = 'history'))
bdl-4errorDocumentReference.contained:documententry.response mandatory for batch-response/transaction-response/history, otherwise prohibited
: entry.all(response.exists() = (%resource.type = 'batch-response' or %resource.type = 'transaction-response' or %resource.type = 'history'))
bdl-7errorDocumentReference.contained:documentFullUrl must be unique in a bundle, or else entries with the same fullUrl must have different meta.versionId (except in history bundles)
: (type = 'history') or entry.where(fullUrl.exists()).select(fullUrl&resource.meta.versionId).isDistinct()
bdl-9errorDocumentReference.contained:documentA document must have an identifier with a system and a value
: type = 'document' implies (identifier.system.exists() and identifier.value.exists())
bdl-10errorDocumentReference.contained:documentA document must have a date
: type = 'document' implies (timestamp.hasValue())
bdl-11errorDocumentReference.contained:documentA document must have a Composition as the first resource
: type = 'document' implies entry.first().resource.is(Composition)
bdl-12errorDocumentReference.contained:documentA message must have a MessageHeader as the first resource
: type = 'message' implies entry.first().resource.is(MessageHeader)
ch-elm-leading-codewarningDocumentReference.contained:documentThe ServiceRequest.code and the Observation.code are in general equal.
: entry.resource.ofType(ServiceRequest).code = entry.resource.ofType(Observation).code
ch-elm-resolveableurlerrorDocumentReference.content.attachmentMust have a resolvable URL.
: url.exists() and url.resolve()
ch-lab-bdl1warningDocumentReference.contained:documentThe resource should be conform to the corresponding EU LAB profile
: conformsTo('http://hl7.eu/fhir/laboratory/StructureDefinition/Bundle-eu-lab')
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()

This structure is derived from PublishDocumentReference

 

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