Uzbekistan Digital Health Platform - Integrations - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

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Resource Profile: Screening Document Reference ( Experimental )

Profile for references to documents (consent forms, protocols) used within the cervical and breast cancer screening system.

Usages:

• Examples for this Profile: DocumentReference/mammography-consent

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DocumentReference	C	0..*	DocumentReference(5.0.0)	A reference to a document Constraints: docRef-1, docRef-2
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
contained		0..*	Resource	Contained, inline Resources
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored Constraints: ext-1
status	?!SΣ	1..1	code	current | superseded | entered-in-error Binding: DocumentReferenceStatus (required)
type	SΣ	0..1	CodeableConcept	Kind of document (LOINC if possible) Binding: FHIRDocumentTypeCodes (required)
subject	SΣ	0..1	Reference(Patient)	Who/what is the subject of the document
context	SC	0..*	Reference(Appointment | Encounter | EpisodeOfCare)	Context of the document content
content	SΣ	1..*	BackboneElement	Document referenced
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
attachment	SΣ	1..1	Attachment	Where to access the document
contentType	ΣC	0..1	code	Mime type of the content, with charset etc. Binding: MimeTypes (required) Required Pattern: application/pdf
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
DocumentReference.status	Base	required	DocumentReferenceStatus	📍5.0.0	FHIR Std.
DocumentReference.type	Base	required	FHIR Document Type Codes	📍5.0.0	FHIR Std.
DocumentReference.content.​attachment.contentType	Base	required	Mime Types	📍5.0.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	DocumentReference	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	DocumentReference	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	DocumentReference	A resource should have narrative for robust management	text.`div`.exists()
docRef-1	warning	DocumentReference	facilityType SHALL only be present if context is not an encounter	facilityType.empty() or context.where(resolve() is Encounter).empty()
docRef-2	warning	DocumentReference	practiceSetting SHALL only be present if context is not present	practiceSetting.empty() or context.where(resolve() is Encounter).empty()
ele-1	error	DocumentReference.implicitRules, DocumentReference.modifierExtension, DocumentReference.status, DocumentReference.type, DocumentReference.subject, DocumentReference.context, DocumentReference.content, DocumentReference.content.modifierExtension, DocumentReference.content.attachment, DocumentReference.content.attachment.contentType	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	DocumentReference.modifierExtension, DocumentReference.content.modifierExtension	Must have either extensions or value[x], not both	extension.exists() != value.exists()

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DocumentReference		0..*	DocumentReference(5.0.0)	A reference to a document
status	S	1..1	code	current | superseded | entered-in-error Binding: DocumentReferenceStatus (required)
modality		0..0		Imaging modality used
type	S	0..1	CodeableConcept	Kind of document (LOINC if possible) Binding: FHIRDocumentTypeCodes (required)
subject	S	0..1	Reference(Patient)	Who/what is the subject of the document
context	S	0..*	Reference(Appointment | Encounter | EpisodeOfCare)	Context of the document content
content	S	1..*	BackboneElement	Document referenced
attachment	S	1..1	Attachment	Where to access the document
contentType		0..1	code	Mime type of the content, with charset etc. Binding: MimeTypes (required) Required Pattern: application/pdf
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
DocumentReference.status	Base	required	DocumentReferenceStatus	📍5.0.0	FHIR Std.
DocumentReference.type	Base	required	FHIR Document Type Codes	📍5.0.0	FHIR Std.
DocumentReference.content.​attachment.contentType	Base	required	Mime Types	📍5.0.0	FHIR Std.

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DocumentReference	C	0..*	DocumentReference(5.0.0)	A reference to a document Constraints: docRef-1, docRef-2
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: AllLanguages (required): IETF language tag for a human language Additional Bindings Purpose CommonLanguages Starter
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored Constraints: ext-1
identifier	Σ	0..*	Identifier	Business identifiers for the document
version	Σ	0..1	string	An explicitly assigned identifer of a variation of the content in the DocumentReference
basedOn		0..*	Reference(Appointment | AppointmentResponse | CarePlan | Claim | CommunicationRequest | Contract | CoverageEligibilityRequest | DeviceRequest | EnrollmentRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | RequestOrchestration | ServiceRequest | SupplyRequest | VisionPrescription)	Procedure that caused this media to be created
status	?!SΣ	1..1	code	current | superseded | entered-in-error Binding: DocumentReferenceStatus (required)
docStatus	Σ	0..1	code	registered | partial | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | deprecated | unknown Binding: CompositionStatus (required): Status of the underlying document.
type	SΣ	0..1	CodeableConcept	Kind of document (LOINC if possible) Binding: FHIRDocumentTypeCodes (required)
category	Σ	0..*	CodeableConcept	Categorization of document Binding: ReferencedItemCategoryValueSet (example): High-level kind of document at a macro level.
subject	SΣ	0..1	Reference(Patient)	Who/what is the subject of the document
context	SC	0..*	Reference(Appointment | Encounter | EpisodeOfCare)	Context of the document content
event		0..*	CodeableReference()	Main clinical acts documented Binding: ActCode (3.0.0) (example): This list of codes represents the main clinical acts being documented.
bodySite	Σ	0..*	CodeableReference(BodyStructure)	Body part included Binding: SNOMEDCTBodyStructures (example): SNOMED CT Body site concepts
facilityType	C	0..1	CodeableConcept	Kind of facility where patient was seen Binding: FacilityTypeCodeValueSet (example): XDS Facility Type.
practiceSetting	C	0..1	CodeableConcept	Additional details about where the content was created (e.g. clinical specialty) Binding: PracticeSettingCodeValueSet (example): Additional details about where the content was created (e.g. clinical specialty).
period	Σ	0..1	Period	Time of service that is being documented
date	Σ	0..1	instant	When this document reference was created
author	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson | CareTeam)	Who and/or what authored the document
attester		0..*	BackboneElement	Attests to accuracy of the document
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
mode		1..1	CodeableConcept	personal | professional | legal | official Binding: CompositionAttestationMode (preferred): The way in which a person authenticated a document.
time		0..1	dateTime	When the document was attested
party		0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization)	Who attested the document
custodian		0..1	Reference(Organization)	Organization which maintains the document
relatesTo	Σ	0..*	BackboneElement	Relationships to other documents
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
code	Σ	1..1	CodeableConcept	The relationship type with another document Binding: DocumentRelationshipType (extensible): The type of relationship between the documents.
target	Σ	1..1	Reference(DocumentReference)	Target of the relationship
description	Σ	0..1	markdown	Human-readable description
securityLabel	Σ	0..*	CodeableConcept	Document security-tags Binding: SecurityLabelExamples (example): Example Security Labels from the Healthcare Privacy and Security Classification System.
content	SΣ	1..*	BackboneElement	Document referenced
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
attachment	SΣ	1..1	Attachment	Where to access the document
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
contentType	ΣC	0..1	code	Mime type of the content, with charset etc. Binding: MimeTypes (required) Required Pattern: application/pdf
language	Σ	0..1	code	Human language of the content (BCP-47) Binding: AllLanguages (required): IETF language tag for a human language. Additional Bindings Purpose CommonLanguages Starter Example General: en-AU
data	C	0..1	base64Binary	Data inline, base64ed
url	Σ	0..1	url	Uri where the data can be found Example General: http://www.acme.com/logo-small.png
size	Σ	0..1	integer64	Number of bytes of content (if url provided)
hash	Σ	0..1	base64Binary	Hash of the data (sha-1, base64ed)
title	Σ	0..1	string	Label to display in place of the data Example General: Official Corporate Logo
creation	Σ	0..1	dateTime	Date attachment was first created
height		0..1	positiveInt	Height of the image in pixels (photo/video)
width		0..1	positiveInt	Width of the image in pixels (photo/video)
frames		0..1	positiveInt	Number of frames if > 1 (photo)
duration		0..1	decimal	Length in seconds (audio / video)
pages		0..1	positiveInt	Number of printed pages
profile	Σ	0..*	BackboneElement	Content profile rules for the document
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
value[x]	Σ	1..1		Code|uri|canonical Binding: HL7FormatCodes (2.1.0) (preferred): Document Format Codes.
valueCoding			Coding
valueUri			uri
valueCanonical			canonical(Any)
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
DocumentReference.language	Base	required	All Languages	📍5.0.0	FHIR Std.
DocumentReference.status	Base	required	DocumentReferenceStatus	📍5.0.0	FHIR Std.
DocumentReference.docStatus	Base	required	Composition Status	📍5.0.0	FHIR Std.
DocumentReference.type	Base	required	FHIR Document Type Codes	📍5.0.0	FHIR Std.
DocumentReference.category	Base	example	Referenced Item Category Value Set	📍5.0.0	FHIR Std.
DocumentReference.event	Base	example	v3 Code System ActCode	📍3.0.0	THO v7.2
DocumentReference.bodySite	Base	example	SNOMED CT Body Structures	📍5.0.0	FHIR Std.
DocumentReference.facilityType	Base	example	Facility Type Code Value Set	📍5.0.0	FHIR Std.
DocumentReference.practiceSetting	Base	example	Practice Setting Code Value Set	📍5.0.0	FHIR Std.
DocumentReference.attester.​mode	Base	preferred	Composition Attestation Mode	📍5.0.0	FHIR Std.
DocumentReference.relatesTo.​code	Base	extensible	Document Relationship Type	📍5.0.0	FHIR Std.
DocumentReference.securityLabel	Base	example	Example set of Security Labels	📍5.0.0	FHIR Std.
DocumentReference.content.​attachment.contentType	Base	required	Mime Types	📍5.0.0	FHIR Std.
DocumentReference.content.​attachment.language	Base	required	All Languages	📍5.0.0	FHIR Std.
DocumentReference.content.​profile.value[x]	Base	preferred	HL7 ValueSet of Format Codes for use with Document Sharing	📍2.1.0	THO v7.2

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	DocumentReference	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	DocumentReference	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	DocumentReference	A resource should have narrative for robust management	text.`div`.exists()
docRef-1	warning	DocumentReference	facilityType SHALL only be present if context is not an encounter	facilityType.empty() or context.where(resolve() is Encounter).empty()
docRef-2	warning	DocumentReference	practiceSetting SHALL only be present if context is not present	practiceSetting.empty() or context.where(resolve() is Encounter).empty()
ele-1	error	DocumentReference.meta, DocumentReference.implicitRules, DocumentReference.language, DocumentReference.text, DocumentReference.extension, DocumentReference.modifierExtension, DocumentReference.identifier, DocumentReference.version, DocumentReference.basedOn, DocumentReference.status, DocumentReference.docStatus, DocumentReference.type, DocumentReference.category, DocumentReference.subject, DocumentReference.context, DocumentReference.event, DocumentReference.bodySite, DocumentReference.facilityType, DocumentReference.practiceSetting, DocumentReference.period, DocumentReference.date, DocumentReference.author, DocumentReference.attester, DocumentReference.attester.extension, DocumentReference.attester.modifierExtension, DocumentReference.attester.mode, DocumentReference.attester.time, DocumentReference.attester.party, DocumentReference.custodian, DocumentReference.relatesTo, DocumentReference.relatesTo.extension, DocumentReference.relatesTo.modifierExtension, DocumentReference.relatesTo.code, DocumentReference.relatesTo.target, DocumentReference.description, DocumentReference.securityLabel, DocumentReference.content, DocumentReference.content.extension, DocumentReference.content.modifierExtension, DocumentReference.content.attachment, DocumentReference.content.attachment.extension, DocumentReference.content.attachment.contentType, DocumentReference.content.attachment.language, DocumentReference.content.attachment.data, DocumentReference.content.attachment.url, DocumentReference.content.attachment.size, DocumentReference.content.attachment.hash, DocumentReference.content.attachment.title, DocumentReference.content.attachment.creation, DocumentReference.content.attachment.height, DocumentReference.content.attachment.width, DocumentReference.content.attachment.frames, DocumentReference.content.attachment.duration, DocumentReference.content.attachment.pages, DocumentReference.content.profile, DocumentReference.content.profile.extension, DocumentReference.content.profile.modifierExtension, DocumentReference.content.profile.value[x]	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	DocumentReference.extension, DocumentReference.modifierExtension, DocumentReference.attester.extension, DocumentReference.attester.modifierExtension, DocumentReference.relatesTo.extension, DocumentReference.relatesTo.modifierExtension, DocumentReference.content.extension, DocumentReference.content.modifierExtension, DocumentReference.content.attachment.extension, DocumentReference.content.profile.extension, DocumentReference.content.profile.modifierExtension	Must have either extensions or value[x], not both	extension.exists() != value.exists()

Summary

Must-Support: 6 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

• Patient (http://hl7.org/fhir/StructureDefinition/Patient|5.0.0)

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DocumentReference	C	0..*	DocumentReference(5.0.0)	A reference to a document Constraints: docRef-1, docRef-2
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
contained		0..*	Resource	Contained, inline Resources
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored Constraints: ext-1
status	?!SΣ	1..1	code	current | superseded | entered-in-error Binding: DocumentReferenceStatus (required)
type	SΣ	0..1	CodeableConcept	Kind of document (LOINC if possible) Binding: FHIRDocumentTypeCodes (required)
subject	SΣ	0..1	Reference(Patient)	Who/what is the subject of the document
context	SC	0..*	Reference(Appointment | Encounter | EpisodeOfCare)	Context of the document content
content	SΣ	1..*	BackboneElement	Document referenced
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
attachment	SΣ	1..1	Attachment	Where to access the document
contentType	ΣC	0..1	code	Mime type of the content, with charset etc. Binding: MimeTypes (required) Required Pattern: application/pdf
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
DocumentReference.status	Base	required	DocumentReferenceStatus	📍5.0.0	FHIR Std.
DocumentReference.type	Base	required	FHIR Document Type Codes	📍5.0.0	FHIR Std.
DocumentReference.content.​attachment.contentType	Base	required	Mime Types	📍5.0.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	DocumentReference	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	DocumentReference	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	DocumentReference	A resource should have narrative for robust management	text.`div`.exists()
docRef-1	warning	DocumentReference	facilityType SHALL only be present if context is not an encounter	facilityType.empty() or context.where(resolve() is Encounter).empty()
docRef-2	warning	DocumentReference	practiceSetting SHALL only be present if context is not present	practiceSetting.empty() or context.where(resolve() is Encounter).empty()
ele-1	error	DocumentReference.implicitRules, DocumentReference.modifierExtension, DocumentReference.status, DocumentReference.type, DocumentReference.subject, DocumentReference.context, DocumentReference.content, DocumentReference.content.modifierExtension, DocumentReference.content.attachment, DocumentReference.content.attachment.contentType	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	DocumentReference.modifierExtension, DocumentReference.content.modifierExtension	Must have either extensions or value[x], not both	extension.exists() != value.exists()

Differential View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DocumentReference		0..*	DocumentReference(5.0.0)	A reference to a document
status	S	1..1	code	current | superseded | entered-in-error Binding: DocumentReferenceStatus (required)
modality		0..0		Imaging modality used
type	S	0..1	CodeableConcept	Kind of document (LOINC if possible) Binding: FHIRDocumentTypeCodes (required)
subject	S	0..1	Reference(Patient)	Who/what is the subject of the document
context	S	0..*	Reference(Appointment | Encounter | EpisodeOfCare)	Context of the document content
content	S	1..*	BackboneElement	Document referenced
attachment	S	1..1	Attachment	Where to access the document
contentType		0..1	code	Mime type of the content, with charset etc. Binding: MimeTypes (required) Required Pattern: application/pdf
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
DocumentReference.status	Base	required	DocumentReferenceStatus	📍5.0.0	FHIR Std.
DocumentReference.type	Base	required	FHIR Document Type Codes	📍5.0.0	FHIR Std.
DocumentReference.content.​attachment.contentType	Base	required	Mime Types	📍5.0.0	FHIR Std.

Snapshot ViewView

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DocumentReference	C	0..*	DocumentReference(5.0.0)	A reference to a document Constraints: docRef-1, docRef-2
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: AllLanguages (required): IETF language tag for a human language Additional Bindings Purpose CommonLanguages Starter
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored Constraints: ext-1
identifier	Σ	0..*	Identifier	Business identifiers for the document
version	Σ	0..1	string	An explicitly assigned identifer of a variation of the content in the DocumentReference
basedOn		0..*	Reference(Appointment | AppointmentResponse | CarePlan | Claim | CommunicationRequest | Contract | CoverageEligibilityRequest | DeviceRequest | EnrollmentRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | RequestOrchestration | ServiceRequest | SupplyRequest | VisionPrescription)	Procedure that caused this media to be created
status	?!SΣ	1..1	code	current | superseded | entered-in-error Binding: DocumentReferenceStatus (required)
docStatus	Σ	0..1	code	registered | partial | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | deprecated | unknown Binding: CompositionStatus (required): Status of the underlying document.
type	SΣ	0..1	CodeableConcept	Kind of document (LOINC if possible) Binding: FHIRDocumentTypeCodes (required)
category	Σ	0..*	CodeableConcept	Categorization of document Binding: ReferencedItemCategoryValueSet (example): High-level kind of document at a macro level.
subject	SΣ	0..1	Reference(Patient)	Who/what is the subject of the document
context	SC	0..*	Reference(Appointment | Encounter | EpisodeOfCare)	Context of the document content
event		0..*	CodeableReference()	Main clinical acts documented Binding: ActCode (3.0.0) (example): This list of codes represents the main clinical acts being documented.
bodySite	Σ	0..*	CodeableReference(BodyStructure)	Body part included Binding: SNOMEDCTBodyStructures (example): SNOMED CT Body site concepts
facilityType	C	0..1	CodeableConcept	Kind of facility where patient was seen Binding: FacilityTypeCodeValueSet (example): XDS Facility Type.
practiceSetting	C	0..1	CodeableConcept	Additional details about where the content was created (e.g. clinical specialty) Binding: PracticeSettingCodeValueSet (example): Additional details about where the content was created (e.g. clinical specialty).
period	Σ	0..1	Period	Time of service that is being documented
date	Σ	0..1	instant	When this document reference was created
author	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson | CareTeam)	Who and/or what authored the document
attester		0..*	BackboneElement	Attests to accuracy of the document
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
mode		1..1	CodeableConcept	personal | professional | legal | official Binding: CompositionAttestationMode (preferred): The way in which a person authenticated a document.
time		0..1	dateTime	When the document was attested
party		0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization)	Who attested the document
custodian		0..1	Reference(Organization)	Organization which maintains the document
relatesTo	Σ	0..*	BackboneElement	Relationships to other documents
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
code	Σ	1..1	CodeableConcept	The relationship type with another document Binding: DocumentRelationshipType (extensible): The type of relationship between the documents.
target	Σ	1..1	Reference(DocumentReference)	Target of the relationship
description	Σ	0..1	markdown	Human-readable description
securityLabel	Σ	0..*	CodeableConcept	Document security-tags Binding: SecurityLabelExamples (example): Example Security Labels from the Healthcare Privacy and Security Classification System.
content	SΣ	1..*	BackboneElement	Document referenced
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
attachment	SΣ	1..1	Attachment	Where to access the document
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
contentType	ΣC	0..1	code	Mime type of the content, with charset etc. Binding: MimeTypes (required) Required Pattern: application/pdf
language	Σ	0..1	code	Human language of the content (BCP-47) Binding: AllLanguages (required): IETF language tag for a human language. Additional Bindings Purpose CommonLanguages Starter Example General: en-AU
data	C	0..1	base64Binary	Data inline, base64ed
url	Σ	0..1	url	Uri where the data can be found Example General: http://www.acme.com/logo-small.png
size	Σ	0..1	integer64	Number of bytes of content (if url provided)
hash	Σ	0..1	base64Binary	Hash of the data (sha-1, base64ed)
title	Σ	0..1	string	Label to display in place of the data Example General: Official Corporate Logo
creation	Σ	0..1	dateTime	Date attachment was first created
height		0..1	positiveInt	Height of the image in pixels (photo/video)
width		0..1	positiveInt	Width of the image in pixels (photo/video)
frames		0..1	positiveInt	Number of frames if > 1 (photo)
duration		0..1	decimal	Length in seconds (audio / video)
pages		0..1	positiveInt	Number of printed pages
profile	Σ	0..*	BackboneElement	Content profile rules for the document
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
value[x]	Σ	1..1		Code|uri|canonical Binding: HL7FormatCodes (2.1.0) (preferred): Document Format Codes.
valueCoding			Coding
valueUri			uri
valueCanonical			canonical(Any)
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
DocumentReference.language	Base	required	All Languages	📍5.0.0	FHIR Std.
DocumentReference.status	Base	required	DocumentReferenceStatus	📍5.0.0	FHIR Std.
DocumentReference.docStatus	Base	required	Composition Status	📍5.0.0	FHIR Std.
DocumentReference.type	Base	required	FHIR Document Type Codes	📍5.0.0	FHIR Std.
DocumentReference.category	Base	example	Referenced Item Category Value Set	📍5.0.0	FHIR Std.
DocumentReference.event	Base	example	v3 Code System ActCode	📍3.0.0	THO v7.2
DocumentReference.bodySite	Base	example	SNOMED CT Body Structures	📍5.0.0	FHIR Std.
DocumentReference.facilityType	Base	example	Facility Type Code Value Set	📍5.0.0	FHIR Std.
DocumentReference.practiceSetting	Base	example	Practice Setting Code Value Set	📍5.0.0	FHIR Std.
DocumentReference.attester.​mode	Base	preferred	Composition Attestation Mode	📍5.0.0	FHIR Std.
DocumentReference.relatesTo.​code	Base	extensible	Document Relationship Type	📍5.0.0	FHIR Std.
DocumentReference.securityLabel	Base	example	Example set of Security Labels	📍5.0.0	FHIR Std.
DocumentReference.content.​attachment.contentType	Base	required	Mime Types	📍5.0.0	FHIR Std.
DocumentReference.content.​attachment.language	Base	required	All Languages	📍5.0.0	FHIR Std.
DocumentReference.content.​profile.value[x]	Base	preferred	HL7 ValueSet of Format Codes for use with Document Sharing	📍2.1.0	THO v7.2

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	DocumentReference	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	DocumentReference	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	DocumentReference	A resource should have narrative for robust management	text.`div`.exists()
docRef-1	warning	DocumentReference	facilityType SHALL only be present if context is not an encounter	facilityType.empty() or context.where(resolve() is Encounter).empty()
docRef-2	warning	DocumentReference	practiceSetting SHALL only be present if context is not present	practiceSetting.empty() or context.where(resolve() is Encounter).empty()
ele-1	error	DocumentReference.meta, DocumentReference.implicitRules, DocumentReference.language, DocumentReference.text, DocumentReference.extension, DocumentReference.modifierExtension, DocumentReference.identifier, DocumentReference.version, DocumentReference.basedOn, DocumentReference.status, DocumentReference.docStatus, DocumentReference.type, DocumentReference.category, DocumentReference.subject, DocumentReference.context, DocumentReference.event, DocumentReference.bodySite, DocumentReference.facilityType, DocumentReference.practiceSetting, DocumentReference.period, DocumentReference.date, DocumentReference.author, DocumentReference.attester, DocumentReference.attester.extension, DocumentReference.attester.modifierExtension, DocumentReference.attester.mode, DocumentReference.attester.time, DocumentReference.attester.party, DocumentReference.custodian, DocumentReference.relatesTo, DocumentReference.relatesTo.extension, DocumentReference.relatesTo.modifierExtension, DocumentReference.relatesTo.code, DocumentReference.relatesTo.target, DocumentReference.description, DocumentReference.securityLabel, DocumentReference.content, DocumentReference.content.extension, DocumentReference.content.modifierExtension, DocumentReference.content.attachment, DocumentReference.content.attachment.extension, DocumentReference.content.attachment.contentType, DocumentReference.content.attachment.language, DocumentReference.content.attachment.data, DocumentReference.content.attachment.url, DocumentReference.content.attachment.size, DocumentReference.content.attachment.hash, DocumentReference.content.attachment.title, DocumentReference.content.attachment.creation, DocumentReference.content.attachment.height, DocumentReference.content.attachment.width, DocumentReference.content.attachment.frames, DocumentReference.content.attachment.duration, DocumentReference.content.attachment.pages, DocumentReference.content.profile, DocumentReference.content.profile.extension, DocumentReference.content.profile.modifierExtension, DocumentReference.content.profile.value[x]	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	DocumentReference.extension, DocumentReference.modifierExtension, DocumentReference.attester.extension, DocumentReference.attester.modifierExtension, DocumentReference.relatesTo.extension, DocumentReference.relatesTo.modifierExtension, DocumentReference.content.extension, DocumentReference.content.modifierExtension, DocumentReference.content.attachment.extension, DocumentReference.content.profile.extension, DocumentReference.content.profile.modifierExtension	Must have either extensions or value[x], not both	extension.exists() != value.exists()

Summary

Must-Support: 6 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

• Patient (http://hl7.org/fhir/StructureDefinition/Patient|5.0.0)

Other representations of profile: CSV, Excel, Schematron