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ValueSet
default
A set of rules of how a particular interoperability or standards problem is solved - typically through the use of FHIR resources. This resource is used to gather all the parts of an implementation guide into a logical whole and to publish a computable definition of all the parts.
ImplementationGuide
Path
ImplementationGuide
Id
ImplementationGuide
Cardinality
0 - *
Definition
A set of rules of how a particular interoperability or standards problem is solved - typically through the use of FHIR resources. This resource is used to gather all the parts of an implementation guide into a logical whole and to publish a computable definition of all the parts.
Comment
Constraint
cnl-0 [warning]
Name should be usable as an identifier for the module by machine processing applications such as code generation
ig-2 [error]
If a resource has a fhirVersion, it must be one of the versions defined for the Implementation Guide
Path
ImplementationGuide.url
Id
ImplementationGuide.url
Type
Cardinality
1 - 1
Definition
An absolute URI that is used to identify this implementation guide when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which an authoritative instance of this implementation guide is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the implementation guide is stored on different servers.
Comment
Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred. Multiple instances may share the same URL if they have a distinct version.
The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author. Considerations for making this decision are found in [Technical and Business Versions](resource.html#versions).
In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the [meta.source](resource.html#meta) element to indicate where the current master source of the resource can be found.
Requirements
Allows the implementation guide to be referenced by a single globally unique identifier. This is required to allow hosting Implementation Guides on multiple different servers, and to allow for the editorial process.
Constraint
cnl-1 [warning]
URL should not contain | or # - these characters make processing canonical references problematic
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.identifier
Id
ImplementationGuide.identifier
Type
Cardinality
0 - *
Definition
A formal identifier that is used to identify this implementation guide when it is represented in other formats, or referenced in a specification, model, design or an instance.
Comment
Requirements
Allows externally provided and/or usable business identifiers to be easily associated with the module.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.identifier.Identifier.use
Id
Identifier.use
Type
Cardinality
0 - 1
Definition
The purpose of this identifier.
Comment
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Requirements
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Binding
Strength
required
Description
Identifies the purpose for this identifier, if known .
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.identifier.Identifier.type
Id
Identifier.type
Type
Cardinality
0 - 1
Definition
A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Comment
This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Requirements
Allows users to make use of identifiers when the identifier system is not known.
Binding
Strength
extensible
Description
A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.identifier.Identifier.type.CodeableConcept.coding
Id
CodeableConcept.coding
Type
Cardinality
0 - *
Definition
A reference to a code defined by a terminology system.
Comment
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Requirements
Allows for alternative encodings within a code system, and translations to other code systems.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.identifier.Identifier.type.CodeableConcept.coding.Coding.system
Id
Coding.system
Type
Cardinality
0 - 1
Definition
The identification of the code system that defines the meaning of the symbol in the code.
Comment
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should be an absolute reference to some definition that establishes the system clearly and unambiguously.
Requirements
Need to be unambiguous about the source of the definition of the symbol.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.identifier.Identifier.type.CodeableConcept.coding.Coding.version
Id
Coding.version
Type
Cardinality
0 - 1
Definition
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Comment
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.identifier.Identifier.type.CodeableConcept.coding.Coding.code
Id
Coding.code
Type
Cardinality
0 - 1
Definition
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Comment
Requirements
Need to refer to a particular code in the system.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
cod-1
Path
ImplementationGuide.identifier.Identifier.type.CodeableConcept.coding.Coding.display
Id
Coding.display
Type
Cardinality
0 - 1
Definition
A representation of the meaning of the code in the system, following the rules of the system.
Comment
Requirements
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
cod-1
Path
ImplementationGuide.identifier.Identifier.type.CodeableConcept.coding.Coding.userSelected
Id
Coding.userSelected
Type
Cardinality
0 - 1
Definition
Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Comment
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Requirements
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.identifier.Identifier.system
Id
Identifier.system
Type
Cardinality
0 - 1
Definition
Establishes the namespace for the value - that is, an absolute URL that describes a set values that are unique.
Comment
Identifier.system is always case sensitive.
Requirements
There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.identifier.Identifier.value
Id
Identifier.value
Type
Cardinality
0 - 1
Definition
The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Comment
If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the [http://hl7.org/fhir/StructureDefinition/rendered-value](http://hl7.org/fhir/extensions/StructureDefinition-rendered-value.html)). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
ident-1
Path
ImplementationGuide.identifier.Identifier.period
Id
Identifier.period
Type
Cardinality
0 - 1
Definition
Time period during which identifier is/was valid for use.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.identifier.Identifier.period.Period.start
Id
Period.start
Type
Cardinality
0 - 1
Definition
The start of the period. The boundary is inclusive.
Comment
If the low element is missing, the meaning is that the low boundary is not known.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
per-1
Path
ImplementationGuide.identifier.Identifier.period.Period.end
Id
Period.end
Type
Cardinality
0 - 1
Definition
The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.
Comment
The end value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
per-1
Path
ImplementationGuide.identifier.Identifier.assigner
Id
Identifier.assigner
Type
Cardinality
0 - 1
Definition
Organization that issued/manages the identifier.
Comment
The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.identifier.Identifier.assigner.Reference.reference
Id
Reference.reference
Type
Cardinality
0 - 1
Definition
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Comment
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
ref-2
ref-1
Path
ImplementationGuide.identifier.Identifier.assigner.Reference.type
Id
Reference.type
Type
Cardinality
0 - 1
Definition
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
Comment
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a known RESTful URL) or by resolving the target of the reference.
Binding
Strength
extensible
Description
Aa resource (or, for logical models, the URI of the logical model).
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.identifier.Identifier.assigner.Reference.identifier
Id
Reference.identifier
Type
Cardinality
0 - 1
Definition
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Comment
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
This element only allows for a single identifier. In the case where additional identifers are required, use the [http://hl7.org/fhir/StructureDefinition/additionalIdentifier](http://hl7.org/fhir/extensions/StructureDefinition-additionalIdentifier.html) extension.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
ref-2
Path
ImplementationGuide.identifier.Identifier.assigner.Reference.identifier.Identifier.use
Id
Identifier.use
Type
Cardinality
0 - 1
Definition
The purpose of this identifier.
Comment
Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Requirements
Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Binding
Strength
required
Description
Identifies the purpose for this identifier, if known .
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.identifier.Identifier.assigner.Reference.identifier.Identifier.type
Id
Identifier.type
Type
Cardinality
0 - 1
Definition
A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Comment
This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Requirements
Allows users to make use of identifiers when the identifier system is not known.
Binding
Strength
extensible
Description
A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.identifier.Identifier.assigner.Reference.identifier.Identifier.system
Id
Identifier.system
Type
Cardinality
0 - 1
Definition
Establishes the namespace for the value - that is, an absolute URL that describes a set values that are unique.
Comment
Identifier.system is always case sensitive.
Requirements
There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.identifier.Identifier.assigner.Reference.identifier.Identifier.value
Id
Identifier.value
Type
Cardinality
0 - 1
Definition
The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Comment
If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the [http://hl7.org/fhir/StructureDefinition/rendered-value](http://hl7.org/fhir/extensions/StructureDefinition-rendered-value.html)). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
ident-1
Path
ImplementationGuide.identifier.Identifier.assigner.Reference.identifier.Identifier.period
Id
Identifier.period
Type
Cardinality
0 - 1
Definition
Time period during which identifier is/was valid for use.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.identifier.Identifier.assigner.Reference.identifier.Identifier.assigner
Id
Identifier.assigner
Type
Cardinality
0 - 1
Definition
Organization that issued/manages the identifier.
Comment
The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.identifier.Identifier.assigner.Reference.display
Id
Reference.display
Type
Cardinality
0 - 1
Definition
Plain text narrative that identifies the resource in addition to the resource reference.
Comment
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
ref-2
Path
ImplementationGuide.version
Id
ImplementationGuide.version
Type
Cardinality
0 - 1
Definition
The identifier that is used to identify this version of the implementation guide when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the implementation guide author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence.
Comment
There may be different implementation guide instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the implementation guide with the format [url]|[version]. The version SHOULD NOT contain a '#' - see [Business Version](resource.html#bv-format).
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.versionAlgorithm[x]
Id
ImplementationGuide.versionAlgorithm[x]
Type
Cardinality
0 - 1
Definition
Indicates the mechanism used to compare versions to determine which is more current.
Comment
If set as a string, this is a FHIRPath expression that has two additional context variables passed in - %version1 and %version2 and will return a negative number if version1 is newer, a positive number if version2 and a 0 if the version ordering can't be successfully be determined.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.name
Id
ImplementationGuide.name
Type
Cardinality
1 - 1
Definition
A natural language name identifying the implementation guide. This name should be usable as an identifier for the module by machine processing applications such as code generation.
Comment
The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.
Requirements
Support human navigation and code generation.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
cnl-0
Path
ImplementationGuide.title
Id
ImplementationGuide.title
Type
Cardinality
0 - 1
Definition
A short, descriptive, user-friendly title for the implementation guide.
Comment
This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.status
Id
ImplementationGuide.status
Type
Cardinality
1 - 1
Definition
The status of this implementation guide. Enables tracking the life-cycle of the content.
Comment
Allows filtering of implementation guides that are appropriate for use versus not.
See guidance around (not) making local changes to elements [here](canonicalresource.html#localization).
Binding
Strength
required
Description
The lifecycle status of an artifact.
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.experimental
Id
ImplementationGuide.experimental
Type
Cardinality
0 - 1
Definition
A Boolean value to indicate that this implementation guide is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage.
Comment
Allows filtering of implementation guides that are appropriate for use versus not.
Requirements
Enables experimental content to be developed following the same lifecycle that would be used for a production-level implementation guide.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.date
Id
ImplementationGuide.date
Type
Cardinality
0 - 1
Definition
The date (and optionally time) when the implementation guide was last significantly changed. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the implementation guide changes.
Comment
The date is often not tracked until the resource is published, but may be present on draft content. Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the implementation guide. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.
See guidance around (not) making local changes to elements [here](canonicalresource.html#localization).
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.publisher
Id
ImplementationGuide.publisher
Type
Cardinality
0 - 1
Definition
The name of the organization or individual responsible for the release and ongoing maintenance of the implementation guide.
Comment
Usually an organization but may be an individual. The publisher (or steward) of the implementation guide is the organization or individual primarily responsible for the maintenance and upkeep of the implementation guide. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the implementation guide. This item SHOULD be populated unless the information is available from context.
Requirements
Helps establish the "authority/credibility" of the implementation guide. May also allow for contact.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.contact
Id
ImplementationGuide.contact
Type
Cardinality
0 - *
Definition
Contact details to assist a user in finding and communicating with the publisher.
Comment
May be a web site, an email address, a telephone number, etc.
See guidance around (not) making local changes to elements [here](canonicalresource.html#localization).
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.contact.ContactDetail.name
Id
ContactDetail.name
Type
Cardinality
0 - 1
Definition
The name of an individual to contact.
Comment
If there is no named individual, the telecom information is for the organization as a whole.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.contact.ContactDetail.telecom
Id
ContactDetail.telecom
Type
Cardinality
0 - *
Definition
The contact details for the individual (if a name was provided) or the organization.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.contact.ContactDetail.telecom.ContactPoint.system
Id
ContactPoint.system
Type
Cardinality
0 - 1
Definition
Telecommunications form for contact point - what communications system is required to make use of the contact.
Comment
Binding
Strength
required
Description
Telecommunications form for contact point.
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
cpt-2
Path
ImplementationGuide.contact.ContactDetail.telecom.ContactPoint.value
Id
ContactPoint.value
Type
Cardinality
0 - 1
Definition
The actual contact point details, in a form that is meaningful to the designated communication system (i.e. phone number or email address).
Comment
Additional text data such as phone extension numbers, or notes about use of the contact are sometimes included in the value.
Requirements
Need to support legacy numbers that are not in a tightly controlled format.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
cpt-2
Path
ImplementationGuide.contact.ContactDetail.telecom.ContactPoint.use
Id
ContactPoint.use
Type
Cardinality
0 - 1
Definition
Identifies the purpose for the contact point.
Comment
Applications can assume that a contact is current unless it explicitly says that it is temporary or old.
Requirements
Need to track the way a person uses this contact, so a user can choose which is appropriate for their purpose.
Binding
Strength
required
Description
Use of contact point.
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.contact.ContactDetail.telecom.ContactPoint.rank
Id
ContactPoint.rank
Type
Cardinality
0 - 1
Definition
Specifies a preferred order in which to use a set of contacts. ContactPoints with lower rank values are more preferred than those with higher rank values.
Comment
Note that rank does not necessarily follow the order in which the contacts are represented in the instance.
Ranks need not be unique. E.g. it's possible to have multiple contacts with rank=1. If the ranks have different systems or uses, this would be interpreted to mean "X is my most preferred phone number, Y is my most preferred email address" or "X is my preferred home email and Y is my preferred work email". If the system and use for equally-ranked contacts are the same, then the level of preference is equivalent for both repetitions.
Ranks need not be sequential and not all repetitions must have a rank. For example, it's possible to have 4 contacts with ranks of 2, 5 and two with no rank specified. That would be interpreted to mean the first is preferred over the second and no preference stated for the remaining contacts.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.contact.ContactDetail.telecom.ContactPoint.period
Id
ContactPoint.period
Type
Cardinality
0 - 1
Definition
Time period when the contact point was/is in use.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.contact.ContactDetail.telecom.ContactPoint.period.Period.start
Id
Period.start
Type
Cardinality
0 - 1
Definition
The start of the period. The boundary is inclusive.
Comment
If the low element is missing, the meaning is that the low boundary is not known.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
per-1
Path
ImplementationGuide.contact.ContactDetail.telecom.ContactPoint.period.Period.end
Id
Period.end
Type
Cardinality
0 - 1
Definition
The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.
Comment
The end value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
per-1
Path
ImplementationGuide.description
Id
ImplementationGuide.description
Type
Cardinality
0 - 1
Definition
A free text natural language description of the implementation guide from a consumer's perspective.
Comment
This description can be used to capture details such as why the implementation guide was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the implementation guide as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the implementation guide is presumed to be the predominant language in the place the implementation guide was created).
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.useContext
Id
ImplementationGuide.useContext
Type
Cardinality
0 - *
Definition
The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate implementation guide instances.
Comment
When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.
Requirements
Assist in searching for appropriate content.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.useContext.UsageContext.code
Id
UsageContext.code
Type
Cardinality
1 - 1
Definition
A code that identifies the type of context being specified by this usage context.
Comment
Binding
Strength
extensible
Description
A code that specifies a type of context being specified by a usage context.
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.useContext.UsageContext.code.Coding.system
Id
Coding.system
Type
Cardinality
0 - 1
Definition
The identification of the code system that defines the meaning of the symbol in the code.
Comment
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should be an absolute reference to some definition that establishes the system clearly and unambiguously.
Requirements
Need to be unambiguous about the source of the definition of the symbol.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.useContext.UsageContext.code.Coding.version
Id
Coding.version
Type
Cardinality
0 - 1
Definition
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Comment
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.useContext.UsageContext.code.Coding.code
Id
Coding.code
Type
Cardinality
0 - 1
Definition
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Comment
Requirements
Need to refer to a particular code in the system.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
cod-1
Path
ImplementationGuide.useContext.UsageContext.code.Coding.display
Id
Coding.display
Type
Cardinality
0 - 1
Definition
A representation of the meaning of the code in the system, following the rules of the system.
Comment
Requirements
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
cod-1
Path
ImplementationGuide.useContext.UsageContext.code.Coding.userSelected
Id
Coding.userSelected
Type
Cardinality
0 - 1
Definition
Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Comment
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Requirements
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.useContext.UsageContext.value[x]
Id
UsageContext.value[x]
Type
Cardinality
1 - 1
Definition
A value that defines the context specified in this context of use. The interpretation of the value is defined by the code.
Comment
Binding
Strength
example
Description
A code that defines the specific value for the context being specified.
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.useContext.UsageContext.value[x].CodeableConcept.coding
Id
CodeableConcept.coding
Type
Cardinality
0 - *
Definition
A reference to a code defined by a terminology system.
Comment
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Requirements
Allows for alternative encodings within a code system, and translations to other code systems.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.useContext.UsageContext.value[x].CodeableConcept.coding.Coding.system
Id
Coding.system
Type
Cardinality
0 - 1
Definition
The identification of the code system that defines the meaning of the symbol in the code.
Comment
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should be an absolute reference to some definition that establishes the system clearly and unambiguously.
Requirements
Need to be unambiguous about the source of the definition of the symbol.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.useContext.UsageContext.value[x].CodeableConcept.coding.Coding.version
Id
Coding.version
Type
Cardinality
0 - 1
Definition
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Comment
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.useContext.UsageContext.value[x].CodeableConcept.coding.Coding.code
Id
Coding.code
Type
Cardinality
0 - 1
Definition
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Comment
Requirements
Need to refer to a particular code in the system.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
cod-1
Path
ImplementationGuide.useContext.UsageContext.value[x].CodeableConcept.coding.Coding.display
Id
Coding.display
Type
Cardinality
0 - 1
Definition
A representation of the meaning of the code in the system, following the rules of the system.
Comment
Requirements
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
cod-1
Path
ImplementationGuide.useContext.UsageContext.value[x].CodeableConcept.coding.Coding.userSelected
Id
Coding.userSelected
Type
Cardinality
0 - 1
Definition
Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Comment
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Requirements
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.jurisdiction
Id
ImplementationGuide.jurisdiction
Type
Cardinality
0 - *
Definition
A legal or geographic region in which the implementation guide is intended to be used.
Comment
It may be possible for the implementation guide to be used in jurisdictions other than those for which it was originally designed or intended.
DEPRECATION NOTE: For consistency, implementations are encouraged to migrate to using the new 'jurisdiction' code in the useContext element. (I.e. useContext.code indicating http://terminology.hl7.org/CodeSystem/usage-context-type#jurisdiction and useContext.valueCodeableConcept indicating the jurisdiction.)
Binding
Strength
extensible
Description
Countries and regions within which this artifact is targeted for use.
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.jurisdiction.CodeableConcept.coding
Id
CodeableConcept.coding
Type
Cardinality
0 - *
Definition
A reference to a code defined by a terminology system.
Comment
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Requirements
Allows for alternative encodings within a code system, and translations to other code systems.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.jurisdiction.CodeableConcept.coding.Coding.system
Id
Coding.system
Type
Cardinality
0 - 1
Definition
The identification of the code system that defines the meaning of the symbol in the code.
Comment
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should be an absolute reference to some definition that establishes the system clearly and unambiguously.
Requirements
Need to be unambiguous about the source of the definition of the symbol.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.jurisdiction.CodeableConcept.coding.Coding.version
Id
Coding.version
Type
Cardinality
0 - 1
Definition
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Comment
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.jurisdiction.CodeableConcept.coding.Coding.code
Id
Coding.code
Type
Cardinality
0 - 1
Definition
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Comment
Requirements
Need to refer to a particular code in the system.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
cod-1
Path
ImplementationGuide.jurisdiction.CodeableConcept.coding.Coding.display
Id
Coding.display
Type
Cardinality
0 - 1
Definition
A representation of the meaning of the code in the system, following the rules of the system.
Comment
Requirements
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
cod-1
Path
ImplementationGuide.jurisdiction.CodeableConcept.coding.Coding.userSelected
Id
Coding.userSelected
Type
Cardinality
0 - 1
Definition
Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Comment
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Requirements
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.purpose
Id
ImplementationGuide.purpose
Type
Cardinality
0 - 1
Definition
Explanation of why this implementation guide is needed and why it has been designed as it has.
Comment
This element does not describe the usage of the implementation guide. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this implementation guide.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.copyright
Id
ImplementationGuide.copyright
Type
Cardinality
0 - 1
Definition
A copyright statement relating to the implementation guide and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the implementation guide.
Comment
...
Requirements
Consumers must be able to determine any legal restrictions on the use of the implementation guide and/or its content.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.copyrightLabel
Id
ImplementationGuide.copyrightLabel
Type
Cardinality
0 - 1
Definition
A short string (<50 characters), suitable for inclusion in a page footer that identifies the copyright holder, effective period, and optionally whether rights are resctricted. (e.g. 'All rights reserved', 'Some rights reserved').
Comment
The (c) symbol should NOT be included in this string. It will be added by software when rendering the notation. Full details about licensing, restrictions, warrantees, etc. goes in the more general 'copyright' element.
Requirements
Defines the content expected to be rendered in all representations of the artifact.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.packageId
Id
ImplementationGuide.packageId
Type
Cardinality
1 - 1
Definition
The NPM package name for this Implementation Guide, used in the NPM package distribution, which is the primary mechanism by which FHIR based tooling manages IG dependencies. This value must be globally unique, and should be assigned with care.
Comment
Many (if not all) IG publishing tools will require that this element be present. For implementation guides published through HL7 or the FHIR foundation, the FHIR product director assigns package IDs.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.license
Id
ImplementationGuide.license
Type
Cardinality
0 - 1
Definition
The license that applies to this Implementation Guide, using an SPDX license code, or 'not-open-source'.
Comment
Binding
Strength
required
Description
The license that applies to an Implementation Guide (using an SPDX license Identifiers, or 'not-open-source'). The binding is required but new SPDX license Identifiers are allowed to be used (https://spdx.org/licenses/).
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.fhirVersion
Id
ImplementationGuide.fhirVersion
Type
Cardinality
1 - *
Definition
The version(s) of the FHIR specification that this ImplementationGuide targets - e.g. describes how to use. The value of this element is the formal version of the specification, without the revision number, e.g. [publication].[major].[minor], which is 4.6.0. for this version.
Comment
Most implementation guides target a single version - e.g. they describe how to use a particular version, and the profiles and examples etc. are valid for that version. But some implementation guides describe how to use multiple different versions of FHIR to solve the same problem, or in concert with each other. Typically, the requirement to support multiple versions arises as implementation matures and different implementation communities are stuck at different versions by regulation or market dynamics.
Binding
Strength
required
Description
All published FHIR Versions.
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
ig-2
Path
ImplementationGuide.dependsOn
Id
ImplementationGuide.dependsOn
Type
Cardinality
0 - *
Definition
Another implementation guide that this implementation depends on. Typically, an implementation guide uses value sets, profiles etc.defined in other implementation guides.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.dependsOn.uri
Id
ImplementationGuide.dependsOn.uri
Type
Cardinality
1 - 1
Definition
A canonical reference to the Implementation guide for the dependency.
Comment
Usually, A canonical reference to the implementation guide is the same as the master location at which the implementation guide is published.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.dependsOn.packageId
Id
ImplementationGuide.dependsOn.packageId
Type
Cardinality
0 - 1
Definition
The NPM package name for the Implementation Guide that this IG depends on.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.dependsOn.version
Id
ImplementationGuide.dependsOn.version
Type
Cardinality
0 - 1
Definition
The version of the IG that is depended on, when the correct version is required to understand the IG correctly.
Comment
This follows the syntax of the NPM packaging version field - see [[reference]].
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.dependsOn.reason
Id
ImplementationGuide.dependsOn.reason
Type
Cardinality
0 - 1
Definition
A description explaining the nature of the dependency on the listed IG.
Comment
This doesn't need to enumerate every resource used, but should give some sense of why the dependency exists. It will be used in the rendered list of dependencies
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.global
Id
ImplementationGuide.global
Type
Cardinality
0 - *
Definition
A set of profiles that all resources covered by this implementation guide must conform to.
Comment
See [Default Profiles](implementationguide.html#default) for a discussion of which resources are 'covered' by an implementation guide.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.global.type
Id
ImplementationGuide.global.type
Type
Cardinality
1 - 1
Definition
The type of resource that all instances must conform to.
Comment
The type must match that of the profile that is referred to but is made explicit here as a denormalization so that a system processing the implementation guide resource knows which resources the profile applies to even if the profile itself is not available.
Binding
Strength
required
Description
One of the resource types defined as part of this version of FHIR.
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.global.profile
Id
ImplementationGuide.global.profile
Type
Cardinality
1 - 1
Definition
A reference to the profile that all instances must conform to.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.definition
Id
ImplementationGuide.definition
Type
Cardinality
0 - 1
Definition
The information needed by an IG publisher tool to publish the whole implementation guide.
Comment
Principally, this consists of information abuot source resource and file locations, and build parameters and templates.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
ig-1 [error]
If a resource has a groupingId, it must refer to a grouping defined in the Implementation Guide
Condition
ig-2
Path
ImplementationGuide.definition.grouping
Id
ImplementationGuide.definition.grouping
Type
Cardinality
0 - *
Definition
A logical group of resources. Logical groups can be used when building pages.
Comment
Groupings are arbitrary sub-divisions of content. Typically, they are used to help build Table of Contents automatically.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
ig-1
Path
ImplementationGuide.definition.grouping.name
Id
ImplementationGuide.definition.grouping.name
Type
Cardinality
1 - 1
Definition
The human-readable title to display for the package of resources when rendering the implementation guide.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.definition.grouping.description
Id
ImplementationGuide.definition.grouping.description
Type
Cardinality
0 - 1
Definition
Human readable text describing the package.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.definition.resource
Id
ImplementationGuide.definition.resource
Type
Cardinality
0 - *
Definition
A resource that is part of the implementation guide. Conformance resources (value set, structure definition, capability statements etc.) are obvious candidates for inclusion, but any kind of resource can be included as an example resource.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
ig-2
ig-1
Path
ImplementationGuide.definition.resource.reference
Id
ImplementationGuide.definition.resource.reference
Type
Cardinality
1 - 1
Definition
Where this resource is found.
Comment
Usually this is a relative URL that locates the resource within the implementation guide. If you authoring an implementation guide, and will publish it using the FHIR publication tooling, use a URI that may point to a resource, or to one of various alternative representations (e.g. spreadsheet). The tooling will convert this when it publishes it.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.definition.resource.reference.Reference.reference
Id
Reference.reference
Type
Cardinality
0 - 1
Definition
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Comment
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
ref-2
ref-1
Path
ImplementationGuide.definition.resource.reference.Reference.type
Id
Reference.type
Type
Cardinality
0 - 1
Definition
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
Comment
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a known RESTful URL) or by resolving the target of the reference.
Binding
Strength
extensible
Description
Aa resource (or, for logical models, the URI of the logical model).
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.definition.resource.reference.Reference.identifier
Id
Reference.identifier
Type
Cardinality
0 - 1
Definition
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Comment
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
This element only allows for a single identifier. In the case where additional identifers are required, use the [http://hl7.org/fhir/StructureDefinition/additionalIdentifier](http://hl7.org/fhir/extensions/StructureDefinition-additionalIdentifier.html) extension.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
ref-2
Path
ImplementationGuide.definition.resource.reference.Reference.display
Id
Reference.display
Type
Cardinality
0 - 1
Definition
Plain text narrative that identifies the resource in addition to the resource reference.
Comment
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
ref-2
Path
ImplementationGuide.definition.resource.fhirVersion
Id
ImplementationGuide.definition.resource.fhirVersion
Type
Cardinality
0 - *
Definition
Indicates the FHIR Version(s) this artifact is intended to apply to. If no versions are specified, the resource is assumed to apply to all the versions stated in ImplementationGuide.fhirVersion.
Comment
The resource SHALL be valid against all the versions it is specified to apply to. If the resource referred to is a StructureDefinition, the fhirVersion stated in the StructureDefinition cannot disagree with the version specified here; the specified versions SHALL include the version specified by the StructureDefinition, and may include additional versions using the [http://hl7.org/fhir/StructureDefinition/structuredefinition-applicable-version](http://hl7.org/fhir/extensions/StructureDefinition-structuredefinition-applicable-version.html) extension.
Binding
Strength
required
Description
All published FHIR Versions.
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
ig-2
Path
ImplementationGuide.definition.resource.name
Id
ImplementationGuide.definition.resource.name
Type
Cardinality
0 - 1
Definition
A human assigned name for the resource. All resources SHOULD have a name, but the name may be extracted from the resource (e.g. ValueSet.name).
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.definition.resource.description
Id
ImplementationGuide.definition.resource.description
Type
Cardinality
0 - 1
Definition
A description of the reason that a resource has been included in the implementation guide.
Comment
This is mostly used with examples to explain why it is present (though they can have extensive comments in the examples).
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.definition.resource.isExample
Id
ImplementationGuide.definition.resource.isExample
Type
Cardinality
0 - 1
Definition
If true, indicates the resource is an example instance.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.definition.resource.profile
Id
ImplementationGuide.definition.resource.profile
Type
Cardinality
0 - *
Definition
If present, indicates profile(s) the instance is valid against.
Comment
Examples:
* StructureDefinition -> Any
* ValueSet -> expansion
* OperationDefinition -> Parameters
* Questionnaire -> QuestionnaireResponse.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.definition.resource.groupingId
Id
ImplementationGuide.definition.resource.groupingId
Type
Cardinality
0 - 1
Definition
Reference to the id of the grouping this resource appears in.
Comment
This must correspond to a group.id element within this implementation guide.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
ig-1
Path
ImplementationGuide.definition.page
Id
ImplementationGuide.definition.page
Type
Cardinality
0 - 1
Definition
A page / section in the implementation guide. The root page is the implementation guide home page.
Comment
Pages automatically become sections if they have sub-pages. By convention, the home page is called index.html.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
ig-3 [error]
Source must be absent if 'generated' is generated
Path
ImplementationGuide.definition.page.source[x]
Id
ImplementationGuide.definition.page.source[x]
Type
Cardinality
0 - 1
Definition
Indicates the URL or the actual content to provide for the page.
Comment
If absent and the page isn't a generated page, this may be inferred from the page name by checking input locations. String is used for XHTML content - sent as an escaped string. FHIR tooling can't support 'direct' XHTML anywhere other than in narrative.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
ig-3
Path
ImplementationGuide.definition.page.name
Id
ImplementationGuide.definition.page.name
Type
Cardinality
1 - 1
Definition
The url by which the page should be known when published.
Comment
This SHALL be a local reference, expressed with respect to the root of the IG output folder. No suffix is required. If no suffix is specified, .html will be appended.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.definition.page.title
Id
ImplementationGuide.definition.page.title
Type
Cardinality
1 - 1
Definition
A short title used to represent this page in navigational structures such as table of contents, bread crumbs, etc.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.definition.page.generation
Id
ImplementationGuide.definition.page.generation
Type
Cardinality
1 - 1
Definition
A code that indicates how the page is generated.
Comment
Binding
Strength
required
Description
A code that indicates how the page is generated.
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
ig-3
Path
ImplementationGuide.definition.page.page
Id
ImplementationGuide.definition.page.page
Type
Cardinality
0 - *
Definition
Nested Pages/Sections under this page.
Comment
The implementation guide breadcrumbs may be generated from this structure.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.definition.parameter
Id
ImplementationGuide.definition.parameter
Type
Cardinality
0 - *
Definition
A set of parameters that defines how the implementation guide is built. The parameters are defined by the relevant tools that build the implementation guides.
Comment
see [confluence](https://confluence.hl7.org/display/FHIR/Implementation+Guide+Parameters) for the parameters defined by the HL7 IG publisher.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.definition.parameter.code
Id
ImplementationGuide.definition.parameter.code
Type
Cardinality
1 - 1
Definition
A tool-specific code that defines the parameter.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.definition.parameter.code.Coding.system
Id
Coding.system
Type
Cardinality
0 - 1
Definition
The identification of the code system that defines the meaning of the symbol in the code.
Comment
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should be an absolute reference to some definition that establishes the system clearly and unambiguously.
Requirements
Need to be unambiguous about the source of the definition of the symbol.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.definition.parameter.code.Coding.version
Id
Coding.version
Type
Cardinality
0 - 1
Definition
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Comment
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.definition.parameter.code.Coding.code
Id
Coding.code
Type
Cardinality
0 - 1
Definition
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Comment
Requirements
Need to refer to a particular code in the system.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
cod-1
Path
ImplementationGuide.definition.parameter.code.Coding.display
Id
Coding.display
Type
Cardinality
0 - 1
Definition
A representation of the meaning of the code in the system, following the rules of the system.
Comment
Requirements
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
cod-1
Path
ImplementationGuide.definition.parameter.code.Coding.userSelected
Id
Coding.userSelected
Type
Cardinality
0 - 1
Definition
Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Comment
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Requirements
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.definition.parameter.value
Id
ImplementationGuide.definition.parameter.value
Type
Cardinality
1 - 1
Definition
Value for named type.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.definition.template
Id
ImplementationGuide.definition.template
Type
Cardinality
0 - *
Definition
A template for building resources.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.definition.template.code
Id
ImplementationGuide.definition.template.code
Type
Cardinality
1 - 1
Definition
Type of template specified.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.definition.template.source
Id
ImplementationGuide.definition.template.source
Type
Cardinality
1 - 1
Definition
The source location for the template.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.definition.template.scope
Id
ImplementationGuide.definition.template.scope
Type
Cardinality
0 - 1
Definition
The scope in which the template applies.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.manifest
Id
ImplementationGuide.manifest
Type
Cardinality
0 - 1
Definition
Information about an assembled implementation guide, created by the publication tooling.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.manifest.rendering
Id
ImplementationGuide.manifest.rendering
Type
Cardinality
0 - 1
Definition
A pointer to official web page, PDF or other rendering of the implementation guide.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.manifest.resource
Id
ImplementationGuide.manifest.resource
Type
Cardinality
1 - *
Definition
A resource that is part of the implementation guide. Conformance resources (value set, structure definition, capability statements etc.) are obvious candidates for inclusion, but any kind of resource can be included as an example resource.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.manifest.resource.reference
Id
ImplementationGuide.manifest.resource.reference
Type
Cardinality
1 - 1
Definition
Where this resource is found.
Comment
Usually this is a relative URL that locates the resource within the implementation guide. If you authoring an implementation guide, and will publish it using the FHIR publication tooling, use a URI that may point to a resource, or to one of various alternative representations (e.g. spreadsheet). The tooling will convert this when it publishes it.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.manifest.resource.reference.Reference.reference
Id
Reference.reference
Type
Cardinality
0 - 1
Definition
A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.
Comment
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
ref-2
ref-1
Path
ImplementationGuide.manifest.resource.reference.Reference.type
Id
Reference.type
Type
Cardinality
0 - 1
Definition
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.
The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
Comment
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a known RESTful URL) or by resolving the target of the reference.
Binding
Strength
extensible
Description
Aa resource (or, for logical models, the URI of the logical model).
ValueSet
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.manifest.resource.reference.Reference.identifier
Id
Reference.identifier
Type
Cardinality
0 - 1
Definition
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
Comment
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.
When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference
Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
This element only allows for a single identifier. In the case where additional identifers are required, use the [http://hl7.org/fhir/StructureDefinition/additionalIdentifier](http://hl7.org/fhir/extensions/StructureDefinition-additionalIdentifier.html) extension.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
ref-2
Path
ImplementationGuide.manifest.resource.reference.Reference.display
Id
Reference.display
Type
Cardinality
0 - 1
Definition
Plain text narrative that identifies the resource in addition to the resource reference.
Comment
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
ref-2
Path
ImplementationGuide.manifest.resource.isExample
Id
ImplementationGuide.manifest.resource.isExample
Type
Cardinality
0 - 1
Definition
If true, indicates the resource is an example instance.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.manifest.resource.profile
Id
ImplementationGuide.manifest.resource.profile
Type
Cardinality
0 - *
Definition
If present, indicates profile(s) the instance is valid against.
Comment
Examples:
* StructureDefinition -> Any
* ValueSet -> expansion
* OperationDefinition -> Parameters
* Questionnaire -> QuestionnaireResponse.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.manifest.resource.relativePath
Id
ImplementationGuide.manifest.resource.relativePath
Type
Cardinality
0 - 1
Definition
The relative path for primary page for this resource within the IG.
Comment
Appending 'rendering' + "/" + this should resolve to the resource page.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.manifest.page
Id
ImplementationGuide.manifest.page
Type
Cardinality
0 - *
Definition
Information about a page within the IG.
Comment
Requirements
Allows validation of hyperlinks from a derived IG to this IG without a local copy of the IG.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.manifest.page.name
Id
ImplementationGuide.manifest.page.name
Type
Cardinality
1 - 1
Definition
Relative path to the page.
Comment
Appending 'rendering' + "/" + this should resolve to the page.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.manifest.page.title
Id
ImplementationGuide.manifest.page.title
Type
Cardinality
0 - 1
Definition
Label for the page intended for human display.
Comment
Requirements
Allows generation of labels for markdown-generated hyperlinks.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.manifest.page.anchor
Id
ImplementationGuide.manifest.page.anchor
Type
Cardinality
0 - *
Definition
The name of an anchor available on the page.
Comment
Appending 'rendering' + "/" + page.name + "#" + page.anchor should resolve to the anchor.
Requirements
Allows validation of hyperlinks from a derived IG to this IG without a local copy of the IG.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.manifest.image
Id
ImplementationGuide.manifest.image
Type
Cardinality
0 - *
Definition
Indicates a relative path to an image that exists within the IG.
Comment
Requirements
Allows validation of image links from a derived IG to this IG without a local copy of the IG.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ImplementationGuide.manifest.other
Id
ImplementationGuide.manifest.other
Type
Cardinality
0 - *
Definition
Indicates the relative path of an additional non-page, non-image file that is part of the IG - e.g. zip, jar and similar files that could be the target of a hyperlink in a derived IG.
Comment
Requirements
Allows validation of links from a derived IG to this IG without a local copy of the IG.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children