CH EPR mHealth (R4)
0.1.2 - Draft Standard for Trial Use
CH EPR mHealth (R4)
0.1.2 - Draft Standard for Trial Use
This page is part of the CH EPR mHealth (R4) (v0.1.2: DSTU 1) based on FHIR R4. . For a full list of available versions, see the Directory of published versions 
IHE MHD Profile on DocumentReference (DocumentEntry) when used in the Provide Transaction with Comprehensive (aka XDS-on-FHIR) Metadata.
The official URL for this profile is:
http://ihe.net/fhir/ihe.mhd.fhir/StructureDefinition/IHE.MHD.Provide.Comprehensive.DocumentReference
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from IHE_MHD_Provide_Minimal_DocumentReference
This structure is derived from IHE_MHD_Provide_Minimal_DocumentReference
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  DocumentReference | 0..* | IHE_MHD_Provide_Minimal_DocumentReference | A reference to a document | |
  type | 1..1 | CodeableConcept | Kind of document (LOINC if possible) | |
| category | 1..* | CodeableConcept | Categorization of document | |
| subject | 1..1 | Reference(Patient) {rb} | Who/what is the subject of the document | |
| date | 1..1 | instant | When this document reference was created | |
| securityLabel | 1..* | CodeableConcept | Document security-tags | |
 content | ||||
 attachment | ||||
| language | 1..1 | code | Human language of the content (BCP-47) | |
 creation | 1..1 | dateTime | Date attachment was first created | |
| format | 1..1 | Coding | Format/content rules for the document | |
 context | ||||
 facilityType | 1..1 | CodeableConcept | Kind of facility where patient was seen | |
| practiceSetting | 1..1 | CodeableConcept | Additional details about where the content was created (e.g. clinical specialty) | |
| Documentation for this format | ||||
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| DocumentReference | 0..* | IHE_MHD_Provide_Minimal_DocumentReference | A reference to a document | |
 id | Σ | 0..1 | string | 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) Max Binding: AllLanguages: A human language. | |
| 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 |
| masterIdentifier | SΣ | 1..1 | Identifier | Master Version Specific Identifier |
| identifier | SΣ | 0..* | Identifier | Other identifiers for the document |
| status | ?!Σ | 1..1 | code | current | superseded | entered-in-error Binding: DocumentReferenceStatus (required): The status of the document reference. |
| type | SΣ | 1..1 | CodeableConcept | Kind of document (LOINC if possible) Binding: DocumentTypeValueSet (preferred): Precise type of clinical document. |
| category | SΣ | 1..* | CodeableConcept | Categorization of document Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level. |
 subject | SΣ | 1..1 | Reference(Patient) {rb} | Who/what is the subject of the document |
| date | SΣ | 1..1 | instant | When this document reference was created |
| author | SΣ | 0..* | Reference() {c} | Who and/or what authored the document |
| authenticator | 0..1 | Reference() {c} | Who/what authenticated 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 | SΣ | 1..1 | BackboneElement | Document referenced |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| attachment | SΣ | 1..1 | Attachment | Where to access the document |
| id | 0..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 | 1..1 | code | Human language of the content (BCP-47) Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language. 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 | Σ | 0..1 | unsignedInt | Number of bytes of content (if url provided) |
| hash | Σ | 0..1 | base64Binary | Hash of the data (sha-1, base64ed) |
| title | Σ | 0..1 | string | Label to display in place of the data Example General: Official Corporate Logo |
| creation | Σ | 1..1 | dateTime | Date attachment was first created |
| format | SΣ | 1..1 | Coding | Format/content rules for the document Binding: http://ihe.net/fhir/ihe.formatcode.fhir/ValueSet/formatcode (preferred) |
| context | Σ | 0..1 | BackboneElement | Clinical context of document |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| encounter | 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 | SΣ | 0..1 | Period | Time of service that is being documented |
| facilityType | S | 1..1 | CodeableConcept | Kind of facility where patient was seen Binding: FacilityTypeCodeValueSet (example): XDS Facility Type. |
| practiceSetting | S | 1..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 | S | 0..1 | Reference() {c} | Patient demographics from source |
| related | 0..* | Reference(Resource) | Related identifiers or resources | |
| Documentation for this format | ||||
This structure is derived from IHE_MHD_Provide_Minimal_DocumentReference
Differential View
This structure is derived from IHE_MHD_Provide_Minimal_DocumentReference
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| DocumentReference | 0..* | IHE_MHD_Provide_Minimal_DocumentReference | A reference to a document | |
| type | 1..1 | CodeableConcept | Kind of document (LOINC if possible) | |
| category | 1..* | CodeableConcept | Categorization of document | |
| subject | 1..1 | Reference(Patient) {rb} | Who/what is the subject of the document | |
| date | 1..1 | instant | When this document reference was created | |
| securityLabel | 1..* | CodeableConcept | Document security-tags | |
| content | ||||
| attachment | ||||
| language | 1..1 | code | Human language of the content (BCP-47) | |
| creation | 1..1 | dateTime | Date attachment was first created | |
| format | 1..1 | Coding | Format/content rules for the document | |
| context | ||||
| facilityType | 1..1 | CodeableConcept | Kind of facility where patient was seen | |
| practiceSetting | 1..1 | CodeableConcept | Additional details about where the content was created (e.g. clinical specialty) | |
| Documentation for this format | ||||
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| DocumentReference | 0..* | IHE_MHD_Provide_Minimal_DocumentReference | A reference to a document | |
| id | Σ | 0..1 | string | 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) Max Binding: AllLanguages: A human language. | |
| 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 |
| masterIdentifier | SΣ | 1..1 | Identifier | Master Version Specific Identifier |
| identifier | SΣ | 0..* | Identifier | Other identifiers for the document |
| status | ?!Σ | 1..1 | code | current | superseded | entered-in-error Binding: DocumentReferenceStatus (required): The status of the document reference. |
| type | SΣ | 1..1 | CodeableConcept | Kind of document (LOINC if possible) Binding: DocumentTypeValueSet (preferred): Precise type of clinical document. |
| category | SΣ | 1..* | CodeableConcept | Categorization of document Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level. |
| subject | SΣ | 1..1 | Reference(Patient) {rb} | Who/what is the subject of the document |
| date | SΣ | 1..1 | instant | When this document reference was created |
| author | SΣ | 0..* | Reference() {c} | Who and/or what authored the document |
| authenticator | 0..1 | Reference() {c} | Who/what authenticated 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 | SΣ | 1..1 | BackboneElement | Document referenced |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| attachment | SΣ | 1..1 | Attachment | Where to access the document |
| id | 0..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 | 1..1 | code | Human language of the content (BCP-47) Binding: CommonLanguages (preferred) Max Binding: AllLanguages: A human language. 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 | Σ | 0..1 | unsignedInt | Number of bytes of content (if url provided) |
| hash | Σ | 0..1 | base64Binary | Hash of the data (sha-1, base64ed) |
| title | Σ | 0..1 | string | Label to display in place of the data Example General: Official Corporate Logo |
| creation | Σ | 1..1 | dateTime | Date attachment was first created |
| format | SΣ | 1..1 | Coding | Format/content rules for the document Binding: http://ihe.net/fhir/ihe.formatcode.fhir/ValueSet/formatcode (preferred) |
| context | Σ | 0..1 | BackboneElement | Clinical context of document |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| encounter | 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 | SΣ | 0..1 | Period | Time of service that is being documented |
| facilityType | S | 1..1 | CodeableConcept | Kind of facility where patient was seen Binding: FacilityTypeCodeValueSet (example): XDS Facility Type. |
| practiceSetting | S | 1..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 | S | 0..1 | Reference() {c} | Patient demographics from source |
| related | 0..* | Reference(Resource) | Related identifiers or resources | |
| Documentation for this format | ||||
Other representations of profile: Schematron
| Path | Conformance | ValueSet |
| DocumentReference.language | preferred | CommonLanguages Max Binding: AllLanguages |
| DocumentReference.status | required | DocumentReferenceStatus |
| DocumentReference.type | preferred | DocumentTypeValueSet |
| DocumentReference.category | example | DocumentClassValueSet |
| DocumentReference.relatesTo.code | required | DocumentRelationshipType |
| DocumentReference.securityLabel | extensible | All Security Labels |
| DocumentReference.content.attachment.contentType | required | Mime Types |
| DocumentReference.content.attachment.language | preferred | CommonLanguages Max Binding: AllLanguages |
| DocumentReference.content.format | preferred | http://ihe.net/fhir/ihe.formatcode.fhir/ValueSet/formatcode |
| DocumentReference.context.event | example | v3.ActCode |
| DocumentReference.context.facilityType | example | FacilityTypeCodeValueSet |
| DocumentReference.context.practiceSetting | example | PracticeSettingCodeValueSet |
| Id | Path | Details | Requirements |
| dom-2 | DocumentReference | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | DocumentReference | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() | |
| dom-4 | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
| dom-5 | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | DocumentReference | A resource should have narrative for robust management : text.`div`.exists() | |
| ele-1 | DocumentReference.meta | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.implicitRules | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.language | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.text | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | DocumentReference.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ele-1 | DocumentReference.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | DocumentReference.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ele-1 | DocumentReference.masterIdentifier | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.identifier | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.status | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.type | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.category | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.subject | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.date | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.author | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.authenticator | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.relatesTo | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.relatesTo.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | DocumentReference.relatesTo.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ele-1 | DocumentReference.relatesTo.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | DocumentReference.relatesTo.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ele-1 | DocumentReference.relatesTo.code | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.relatesTo.target | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.description | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.securityLabel | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.content | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.content.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | DocumentReference.content.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ele-1 | DocumentReference.content.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | DocumentReference.content.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ele-1 | DocumentReference.content.attachment | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.content.attachment.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | DocumentReference.content.attachment.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ele-1 | DocumentReference.content.attachment.contentType | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.content.attachment.language | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.content.attachment.url | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.content.attachment.size | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.content.attachment.hash | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.content.attachment.title | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.content.attachment.creation | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.content.format | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.context | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.context.extension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | DocumentReference.context.extension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ele-1 | DocumentReference.context.modifierExtension | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | DocumentReference.context.modifierExtension | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ele-1 | DocumentReference.context.encounter | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.context.event | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.context.period | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.context.facilityType | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.context.practiceSetting | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.context.sourcePatientInfo | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ele-1 | DocumentReference.context.related | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |