Complex
Primitive
ActivityDefinition
CapabilityStatement
CodeSystem
Composition
ConceptMap
Encounter
Library
List
Measure
MessageHeader
Observation
Patient
PlanDefinition
Questionnaire
Resource
ServiceDefinition
StructureDefinition
StructureMap
ValueSet
default
Base StructureDefinition for ValueSet Resource
ValueSet
Path
ValueSet
Id
ValueSet
Cardinality
0 - *
Definition
A value set specifies a set of codes drawn from one or more code systems.
Comment
Constraint
dom-2 [error]
If the resource is contained in another resource, it SHALL NOT contain nested Resources
dom-1 [error]
If the resource is contained in another resource, it SHALL NOT contain any narrative
dom-4 [error]
If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
dom-3 [error]
If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
vsd-5 [error]
Value set SHALL contain at least one of a compose or an expansion element
Path
ValueSet.url
Id
ValueSet.url
Type
Cardinality
0 - 1
Definition
An absolute URI that is used to identify this value set when it is referenced in a specification, model, design or an instance. This SHALL be a URL, SHOULD be globally unique, and SHOULD be an address at which this value set is (or will be) published. The URL SHOULD include the major version of the value set. For more information see [Technical and Business Versions](resource.html#versions).
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.
Requirements
Allows the value set to be referenced by a single globally unique identifier.
Path
ValueSet.identifier
Id
ValueSet.identifier
Type
Cardinality
0 - *
Definition
A formal identifier that is used to identify this value set when it is represented in other formats, or referenced in a specification, model, design or an instance.
Comment
Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, e.g., to identify this value set outside of FHIR, where it is not possible to use the logical URI.
Requirements
Allows externally provided and/or usable business identifiers to be easily associated with the module.
Path
ValueSet.identifier.Identifier.use
Id
Identifier.use
Type
Cardinality
0 - 1
Definition
The purpose of this identifier.
Comment
This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. 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.
Path
ValueSet.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.
Path
ValueSet.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 translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
Path
ValueSet.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 de-reference to some definition that establish the system clearly and unambiguously.
Requirements
Need to be unambiguous about the source of the definition of the symbol.
Path
ValueSet.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.
Path
ValueSet.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.
Path
ValueSet.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.
Path
ValueSet.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 - i.e. 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.
Path
ValueSet.identifier.Identifier.system
Id
Identifier.system
Type
Cardinality
0 - 1
Definition
Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Comment
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.
Path
ValueSet.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 [Rendered Value extension](extension-rendered-value.html).
Path
ValueSet.identifier.Identifier.period
Id
Identifier.period
Type
Cardinality
0 - 1
Definition
Time period during which identifier is/was valid for use.
Comment
Path
ValueSet.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.
Condition
per-1
Path
ValueSet.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 that the period is ongoing. 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 high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.
Condition
per-1
Path
ValueSet.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.
Path
ValueSet.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.
Condition
ref-1
Path
ValueSet.identifier.Identifier.assigner.Reference.identifier
Id
Reference.identifier
Type
Cardinality
0 - 1
Definition
An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity 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.
Path
ValueSet.identifier.Identifier.assigner.Reference.identifier.Identifier.use
Id
Identifier.use
Type
Cardinality
0 - 1
Definition
The purpose of this identifier.
Comment
This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. 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.
Path
ValueSet.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.
Path
ValueSet.identifier.Identifier.assigner.Reference.identifier.Identifier.system
Id
Identifier.system
Type
Cardinality
0 - 1
Definition
Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Comment
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.
Path
ValueSet.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 [Rendered Value extension](extension-rendered-value.html).
Path
ValueSet.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
Path
ValueSet.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.
Path
ValueSet.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.
Path
ValueSet.version
Id
ValueSet.version
Type
Cardinality
0 - 1
Definition
The identifier that is used to identify this version of the value set when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the value set 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 value set instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a refrence to a particular business version of the value set with the format [url]|[version].
Path
ValueSet.name
Id
ValueSet.name
Type
Cardinality
0 - 1
Definition
A natural language name identifying the value set. 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 alpha-numeric type name to ensure that it is computable friendly. A name should be provided unless the value set is a contained resource (e.g. an anonymous value set in a profile). Most registries will require a name.
Requirements
Support human navigation and code generation.
Path
ValueSet.title
Id
ValueSet.title
Type
Cardinality
0 - 1
Definition
A short, descriptive, user-friendly title for the value set.
Comment
This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.
Path
ValueSet.status
Id
ValueSet.status
Type
Cardinality
1 - 1
Definition
The status of this value set. Enables tracking the life-cycle of the content.
Comment
Allows filtering of value sets that are appropriate for use vs. not.
This is labeled as "Is Modifier" because applications should not use a retired value set without due consideration.
Path
ValueSet.experimental
Id
ValueSet.experimental
Type
Cardinality
0 - 1
Definition
A boolean value to indicate that this value set is authored for testing purposes (or education/evaluation/marketing), and is not intended to be used for genuine usage.
Comment
Allows filtering of value set that are appropriate for use vs. not. This is labeled as "Is Modifier" because applications should not use an experimental value set in production.
Requirements
Enables experimental content to be developed following the same lifecycle that would be used for a production-level value set.
Path
ValueSet.date
Id
ValueSet.date
Type
Cardinality
0 - 1
Definition
The date (and optionally time) when the value set was published. The date must change if and 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 value set changes. (e.g. the 'content logical definition').
Comment
Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the value set. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.
Path
ValueSet.publisher
Id
ValueSet.publisher
Type
Cardinality
0 - 1
Definition
The name of the individual or organization that published the value set.
Comment
Usually an organization, but may be an individual. The publisher (or steward) of the value set is the organization or individual primarily responsible for the maintenance and upkeep of the value set. 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 value set. This item SHOULD be populated unless the information is available from context.
Requirements
Helps establish the "authority/credibility" of the value set. May also allow for contact.
Path
ValueSet.contact
Id
ValueSet.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.
Path
ValueSet.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.
Path
ValueSet.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
Path
ValueSet.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
Condition
cpt-2
Path
ValueSet.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.
Path
ValueSet.contact.ContactDetail.telecom.ContactPoint.use
Id
ContactPoint.use
Type
Cardinality
0 - 1
Definition
Identifies the purpose for the contact point.
Comment
This is labeled as "Is Modifier" because applications should not mistake a temporary or old contact etc.for a current/permanent one. 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.
Path
ValueSet.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. Contacts are ranked with lower values coming before higher values.
Comment
Note that rank does not necessarily follow the order in which the contacts are represented in the instance.
Path
ValueSet.contact.ContactDetail.telecom.ContactPoint.period
Id
ContactPoint.period
Type
Cardinality
0 - 1
Definition
Time period when the contact point was/is in use.
Comment
Path
ValueSet.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.
Condition
per-1
Path
ValueSet.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 that the period is ongoing. 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 high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.
Condition
per-1
Path
ValueSet.description
Id
ValueSet.description
Type
Cardinality
0 - 1
Definition
A free text natural language description of the value set from a consumer's perspective.
Comment
This description can be used to capture details such as why the value set 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 value set 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 profile is presumed to be the predominant language in the place the profile was created). The description is not intended to describe the semantics of the Value Set - there are no intrinsic semantics separate from the codes contained in its expansion. The description should capture its intended use, which is needed for ensuring integrity for its use in models across future changes. A description should be provided unless the value set is a contained resource (e.g. an anonymous value set in a profile). Most registries will require a description.
Path
ValueSet.useContext
Id
ValueSet.useContext
Type
Cardinality
0 - *
Definition
The content was developed with a focus and intent of supporting the contexts that are listed. These terms may be used to assist with indexing and searching for appropriate value set instances.
Comment
When multiple useContexts are specified, there is no expectation whether all or any of the contexts apply.
Requirements
Assist in searching for appropriate content.
Path
ValueSet.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
Path
ValueSet.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 de-reference to some definition that establish the system clearly and unambiguously.
Requirements
Need to be unambiguous about the source of the definition of the symbol.
Path
ValueSet.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.
Path
ValueSet.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.
Path
ValueSet.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.
Path
ValueSet.useContext.UsageContext.code.Coding.userSelected
Id
Coding.userSelected
Type
Cardinality
0 - 1
Definition
Indicates that this coding was chosen by a user directly - i.e. 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.
Path
ValueSet.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
Path
ValueSet.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 translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
Path
ValueSet.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 de-reference to some definition that establish the system clearly and unambiguously.
Requirements
Need to be unambiguous about the source of the definition of the symbol.
Path
ValueSet.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.
Path
ValueSet.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.
Path
ValueSet.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.
Path
ValueSet.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 - i.e. 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.
Path
ValueSet.jurisdiction
Id
ValueSet.jurisdiction
Type
Cardinality
0 - *
Definition
A legal or geographic region in which the value set is intended to be used.
Comment
It may be possible for the value set to be used in jurisdictions other than those for which it was originally designed or intended.
Path
ValueSet.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 translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
Path
ValueSet.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 de-reference to some definition that establish the system clearly and unambiguously.
Requirements
Need to be unambiguous about the source of the definition of the symbol.
Path
ValueSet.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.
Path
ValueSet.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.
Path
ValueSet.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.
Path
ValueSet.jurisdiction.CodeableConcept.coding.Coding.userSelected
Id
Coding.userSelected
Type
Cardinality
0 - 1
Definition
Indicates that this coding was chosen by a user directly - i.e. 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.
Path
ValueSet.immutable
Id
ValueSet.immutable
Type
Cardinality
0 - 1
Definition
If this is set to 'true', then no new versions of the content logical definition can be created. Note: Other metadata might still change.
Comment
Normally immutability is set to 'false', which is the default assumption if it is not populated. Note that the implication is that if this is set to 'true', there may be only one ValueSet version for this definition. Immutability tends to be set to 'true' in one of two cases: - Where the value set, by the nature of its usage, cannot change. For example "All specializations of ACT in ActClassCode" - Where there's no safe way to express the "Purpose" such that someone else could safely make changes to the value set definition. Source workflow control must guarantee that the same URI always yields the same definition.
Path
ValueSet.purpose
Id
ValueSet.purpose
Type
Cardinality
0 - 1
Definition
Explaination of why this value set is needed and why it has been designed as it has.
Comment
This element does not describe the usage of the value set 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 value set.
Path
ValueSet.copyright
Id
ValueSet.copyright
Type
Cardinality
0 - 1
Definition
A copyright statement relating to the value set and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the value set.
Comment
null Frequently, the copyright differs between the value set and the codes that are included. The copyright statement should clearly differentiate between these when required.
Requirements
Consumers must be able to determine any legal restrictions on the use of the value set and/or its content.
Path
ValueSet.extensible
Id
ValueSet.extensible
Type
Cardinality
0 - 1
Definition
Whether this is intended to be used with an extensible binding or not.
Comment
Requirements
It is not required to say whether this intent applies.
Path
ValueSet.compose
Id
ValueSet.compose
Type
Cardinality
0 - 1
Definition
A set of criteria that define the content logical definition of the value set by including or excluding codes from outside this value set. This I also known as the "Content Logical Definition" (CLD).
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
vsd-5
Path
ValueSet.compose.lockedDate
Id
ValueSet.compose.lockedDate
Type
Cardinality
0 - 1
Definition
If a locked date is defined, then the Content Logical Definition must be evaluated using the current version as of the locked date for referenced code system(s) and value set instances where ValueSet.compose.include.version is not defined.
Comment
With a defined lockedDate the value set is considered "Locked". Otherwise, the value set may have different expansions as underlying code systems and/or value sets evolve. The interpretation of lockedDate is often dependent on the context - e.g. a SNOMED CT derived value set with a lockedDate will have a different expansion in USA than in UK. If a value set specifies a version for include and exclude statements, and also specifies a locked date, the specified versions need to be available that date, or the value set will not be usable.
Path
ValueSet.compose.inactive
Id
ValueSet.compose.inactive
Type
Cardinality
0 - 1
Definition
Whether inactive codes - codes that are not approved for current use - are in the value set. If inactive = true, inactive codes are to be included in the expansion, if inactive = false, the inactive codes will not be included in the expansion. If absent, the behavior is determined by the implementation, or by the applicable ExpansionProfile (but generally, inactive codes would be expected to be included).
Comment
Note that in the FHIR terminology framework, "deprecated" does not mean inactive, but in some code systems (e.g. LOINC, deprecated means inactive). Code systems should define what codes are considered to be inactive. If this is not clearly defined (including in the FHIR code system resource), then all codes are assumed to be active.
Path
ValueSet.compose.include
Id
ValueSet.compose.include
Type
Cardinality
1 - *
Definition
Include one or more codes from a code system or other value set(s).
Comment
All the conditions in an include must be true. If a system is listed, all the codes from the system are listed. If one or more filters are listed, all of the filters must apply. If one or more value sets are listed, the codes must be in all the value sets. E.g. each include is 'include all the codes that meet all these conditions'.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
vsd-2 [error]
A value set with concepts or filters SHALL include a system
vsd-3 [error]
Cannot have both concept and filter
vsd-1 [error]
A value set include/exclude SHALL have a value set or a system
Path
ValueSet.compose.include.system
Id
ValueSet.compose.include.system
Type
Cardinality
0 - 1
Definition
An absolute URI which is the code system from which the selected codes come from.
Comment
If there are no codes or filters, the entire code system is included. Note that the set of codes that are included may contain abstract codes. See ''Coding.system'' for further documentation about the correct value for the system element.
Condition
vsd-1
vsd-2
Path
ValueSet.compose.include.version
Id
ValueSet.compose.include.version
Type
Cardinality
0 - 1
Definition
The version of the code system that the codes are selected from.
Comment
This is used when selecting the descendants of a concept - they may change between versions. If no version is specified, then the exact contents of the value set may not be known until a context of use binds it to a particular version.
Path
ValueSet.compose.include.concept
Id
ValueSet.compose.include.concept
Type
Cardinality
0 - *
Definition
Specifies a concept to be included or excluded.
Comment
The list of concepts is considered ordered, though the order may not have any particular significance. Typically, the order of an expansion follows that defined in the compose element.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
vsd-3
Path
ValueSet.compose.include.concept.code
Id
ValueSet.compose.include.concept.code
Type
Cardinality
1 - 1
Definition
Specifies a code for the concept to be included or excluded.
Comment
Expressions are allowed if defined by the underlying code system.
Path
ValueSet.compose.include.concept.display
Id
ValueSet.compose.include.concept.display
Type
Cardinality
0 - 1
Definition
The text to display to the user for this concept in the context of this valueset. If no display is provided, then applications using the value set use the display specified for the code by the system.
Comment
The value set resource allows for an alternative display to be specified for when this concept is used in this particular value set. See notes in the value set narrative about the correct use of this element.
Path
ValueSet.compose.include.concept.designation
Id
ValueSet.compose.include.concept.designation
Type
Cardinality
0 - *
Definition
Additional representations for this concept when used in this value set - other languages, aliases, specialized purposes, used for particular purposes, etc.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ValueSet.compose.include.concept.designation.use
Id
ValueSet.compose.include.concept.designation.use
Type
Cardinality
0 - 1
Definition
A code that details how this designation would be used.
Comment
If no use is provided, the designation can be assumed to be suitable for general display to a human user.
Path
ValueSet.compose.include.concept.designation.value
Id
ValueSet.compose.include.concept.designation.value
Type
Cardinality
1 - 1
Definition
The text value for this designation.
Comment
Path
ValueSet.compose.include.filter
Id
ValueSet.compose.include.filter
Type
Cardinality
0 - *
Definition
Select concepts by specify a matching criteria based on the properties (including relationships) defined by the system. If multiple filters are specified, they SHALL all be true.
Comment
Selecting codes by specifying filters based on properties is only possible where the underlying code system defines appropriate properties. Note that in some cases, the underlying code system defines the logical concepts but not the literal codes for the concepts. In such cases, the literal definitions may be provided by a third party.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
vsd-3
Path
ValueSet.compose.include.filter.property
Id
ValueSet.compose.include.filter.property
Type
Cardinality
1 - 1
Definition
A code that identifies a property defined in the code system.
Comment
Path
ValueSet.compose.include.filter.op
Id
ValueSet.compose.include.filter.op
Type
Cardinality
1 - 1
Definition
The kind of operation to perform as a part of the filter criteria.
Comment
Path
ValueSet.compose.include.filter.value
Id
ValueSet.compose.include.filter.value
Type
Cardinality
1 - 1
Definition
The match value may be either a code defined by the system, or a string value, which is a regex match on the literal string of the property value when the operation is 'regex', or one of the values (true and false), when the operation is 'exists'.
Comment
Use regex matching with care - full regex matching on every SNOMED CT term is prohibitive, for example.
Path
ValueSet.compose.include.valueSet
Id
ValueSet.compose.include.valueSet
Type
Cardinality
0 - *
Definition
Selects concepts found in this value set. This is an absolute URI that is a reference to ValueSet.url.
Comment
The value set URI is either a logical reference to a defined value set such as a [SNOMED CT reference set]{snomedct.html#implicit}, or a direct reference to a value set definition using ValueSet.url. The reference may not refer to an actual FHIR ValueSet resource; in this case, whatever is referred to is an implicit definition of a value set that needs to be clear about how versions are resolved.
Condition
vsd-1
Path
ValueSet.compose.exclude
Id
ValueSet.compose.exclude
Type
Cardinality
0 - *
Definition
Exclude one or more codes from the value set based on code system filters and/or other value sets.
Comment
Usually this is used to selectively exclude codes that were included by subsumption in the inclusions. Any display names specified for the codes are ignored.
Condition
vsd-2
Path
ValueSet.expansion
Id
ValueSet.expansion
Type
Cardinality
0 - 1
Definition
A value set can also be "expanded", where the value set is turned into a simple collection of enumerated codes. This element holds the expansion, if it has been performed.
Comment
Expansion is performed to produce a collection of codes that are ready to use for data entry or validation.
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Condition
vsd-5
Path
ValueSet.expansion.identifier
Id
ValueSet.expansion.identifier
Type
Cardinality
1 - 1
Definition
An identifier that uniquely identifies this expansion of the valueset. Systems may re-use the same identifier as long as the expansion and the definition remain the same, but are not required to do so.
Comment
Typically, this uri is a UUID (e.g. urn:uuid:8230ff20-c97a-4167-a59d-dc2cb9df16dd).
Path
ValueSet.expansion.timestamp
Id
ValueSet.expansion.timestamp
Type
Cardinality
1 - 1
Definition
The time at which the expansion was produced by the expanding system.
Comment
This SHOULD be a fully populated instant, but in some circumstances, value sets are expanded by hand, and the expansion is published without that precision.
Path
ValueSet.expansion.total
Id
ValueSet.expansion.total
Type
Cardinality
0 - 1
Definition
The total number of concepts in the expansion. If the number of concept nodes in this resource is less than the stated number, then the server can return more using the offset parameter.
Comment
Paging only applies to flat expansions.
Path
ValueSet.expansion.offset
Id
ValueSet.expansion.offset
Type
Cardinality
0 - 1
Definition
If paging is being used, the offset at which this resource starts. I.e. this resource is a partial view into the expansion. If paging is not being used, this element SHALL not be present.
Comment
Paging only applies to flat expansions. If a filter is applied, the count is the number of concepts that matched the filter, not the number of concepts in an unfiltered view of the expansion.
Path
ValueSet.expansion.parameter
Id
ValueSet.expansion.parameter
Type
Cardinality
0 - *
Definition
A parameter that controlled the expansion process. These parameters may be used by users of expanded value sets to check whether the expansion is suitable for a particular purpose, or to pick the correct expansion.
Comment
The server decides which parameters to include here, but at a minimum, the list SHOULD include the date, filter, and profile parameters passed to the $expand operation (if any).
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
Path
ValueSet.expansion.parameter.name
Id
ValueSet.expansion.parameter.name
Type
Cardinality
1 - 1
Definition
The name of the parameter.
Comment
The names are assigned at the discretion of the server.
Path
ValueSet.expansion.parameter.value[x]
Id
ValueSet.expansion.parameter.value[x]
Type
Cardinality
0 - 1
Definition
The value of the parameter.
Comment
Path
ValueSet.expansion.contains
Id
ValueSet.expansion.contains
Type
Cardinality
0 - *
Definition
The codes that are contained in the value set expansion.
Comment
Constraint
ele-1 [error]
All FHIR elements must have a @value or children
vsd-6 [error]
SHALL have a code or a display
vsd-9 [error]
Must have a code if not abstract
vsd-10 [error]
Must have a system if a code is present
Path
ValueSet.expansion.contains.system
Id
ValueSet.expansion.contains.system
Type
Cardinality
0 - 1
Definition
An absolute URI which is the code system in which the code for this item in the expansion is defined.
Comment
Path
ValueSet.expansion.contains.abstract
Id
ValueSet.expansion.contains.abstract
Type
Cardinality
0 - 1
Definition
If true, this entry is included in the expansion for navigational purposes, and the user cannot select the code directly as a proper value.
Comment
This should not be understood to exclude its use for searching (e.g. by subsumption testing). The client should know whether it is appropriate for the user to select an abstract code or not.
Path
ValueSet.expansion.contains.inactive
Id
ValueSet.expansion.contains.inactive
Type
Cardinality
0 - 1
Definition
If the concept is inactive in the code system that defines it. Inactive codes are those that are no longer to be used, but are maintained by the code system for understanding legacy data.
Comment
This should only have a value if the concept is inactive.
Path
ValueSet.expansion.contains.version
Id
ValueSet.expansion.contains.version
Type
Cardinality
0 - 1
Definition
The version of this code system that defined this code and/or display. This should only be used with code systems that do not enforce concept permanence.
Comment
The exact value of the version string is specified by the system from which the code is derived.
Path
ValueSet.expansion.contains.code
Id
ValueSet.expansion.contains.code
Type
Cardinality
0 - 1
Definition
The code for this item in the expansion hierarchy. If this code is missing the entry in the hierarchy is a place holder (abstract) and does not represent a valid code in the value set.
Comment
Condition
vsd-6
Path
ValueSet.expansion.contains.display
Id
ValueSet.expansion.contains.display
Type
Cardinality
0 - 1
Definition
The recommended display for this item in the expansion.
Comment
Condition
vsd-6
Path
ValueSet.expansion.contains.designation
Id
ValueSet.expansion.contains.designation
Type
Cardinality
0 - *
Definition
Additional representations for this item - other languages, aliases, specialized purposes, used for particular purposes, etc. These are relevant when the conditions of the expansion do not fix to a single correct representation.
Comment
The designations provided must be based on the value set and code system definitions.
Path
ValueSet.expansion.contains.contains
Id
ValueSet.expansion.contains.contains
Type
Cardinality
0 - *
Definition
Other codes and entries contained under this entry in the hierarchy.
Comment
If the expansion uses this element, there is no implication about the logical relationship between them, and the structure cannot be used for logical inferencing. The structure exists to provide navigational assistance for helping human users to locate codes in the expansion.