A set of healthcare-related information that is assembled together into a single logical package that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. A Composition defines the structure and narrative content necessary for a document. However, a Composition alone does not constitute a document. Rather, the Composition must be the first entry in a Bundle where Bundle.type=document, and any other resources referenced from Composition must be included as subsequent entries in the Bundle (for example Patient, Practitioner, Encounter, etc.).

While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical.

ID lógico deste artefato

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

ID lógico deste artefato

Conjunto de regras utilizadas para a elaboração deste conteúdo

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Idioma do conteúdo do recurso

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

A human language.

Resumo do recurso para interpretação humana

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Recursos contidos neste artefato

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Extensões que não podem ser ignoradas

Identificador independente da versão da Composition

Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate.

Status/Situação da Composition: preliminar, definitivo, alterado, inserido com erro

If a composition is marked as withdrawn, the compositions/documents in the series, or data from the composition or document series, should never be displayed to a user without being clearly marked as untrustworthy. The flag "entered-in-error" is why this element is labeled as a modifier of other elements.

Some reporting work flows require that the original narrative of a final document never be altered; instead, only new narrative can be added. The composition resource has no explicit status for explicitly noting whether this business rule is in effect. This would be handled by an extension if required.

Need to be able to mark interim, amended, or withdrawn compositions or documents.

Tipo da Composition (fixo em 'Sumário Internacional do Paciente)

For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation guides will require a specific LOINC code, or use LOINC as an extensible binding.

Key metadata element describing the composition, used in searching/filtering.

ID exclusivo para referência entre elementos

Conteúdo adicional definido por implementações

Código definido por uma terminologia

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.

Allows for alternative encodings within a code system, and translations to other code systems.

ID exclusivo para referência entre elementos

Conteúdo adicional definido por implementações

Identidficador do sistema de terminologia.

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 reference to some definition that establishes the system clearly and unambiguously.

Need to be unambiguous about the source of the definition of the symbol.

Versão da terminologia LOINC - se relevante

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.

Código conforme terminologia.

Need to refer to a particular code in the system.

Descrição conforme definição da terminologia LOINC

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Se esta codificação foi escolhida diretamente pelo usuário

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.

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.

Representação em texto livre do conceito

Very often the text is the same as a displayName of one of the codings.

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Categorização da Composition

This is a metadata field from XDS/MHD.

Helps humans to assess whether the composition is of interest when viewing an index of compositions or documents.

Sobre quem e/ou sobre o que é a Composition

For clinical documents, this is usually the patient.

Essential metadata for searching for the composition. Identifies who and/or what the composition/document is about.

ID exclusivo para referência entre elementos

Conteúdo adicional definido por implementações

Referência literal, URL relativa, interna ou absoluta

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.

Tipo ao qual a referência se refere (por exemplo,'Paciente')

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 RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Aa resource (or, for logical models, the URI of the logical model).

Referência lógica, quando a referência literal não é conhecida

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).

Texto alternativo para o recurso

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.

Contato assistencial descrito nesta Composition

Provides context for the composition and supports searching.

Data de edição da Composition

The Last Modified Date on the composition may be after the date of the document was attested without being changed.

dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring. When packaged in a document, Bundle.timestamp is the date of packaging.

Quem e/ou o que foi o autor desta Compositon

Identifies who is responsible for the content.

Sumário Internacional do Paciente

For many compositions, the title is the same as the text or a display name of Composition.type (e.g. a "consultation" or "progress note"). Note that CDA does not make title mandatory, but there are no known cases where it is useful for title to be omitted, so it is mandatory here. Feedback on this requirement is welcome during the trial use period.

Códigos que especificam o nível de confidencialidade da Composition

The exact use of this element, and enforcement and issues related to highly sensitive documents are out of scope for the base specification, and delegated to implementation profiles (see security section). This element is labeled as a modifier because highly confidential documents must not be treated as if they are not.

Responsável por atestar a acurácia da Composition

Only list each attester once.

Identifies responsibility for the accuracy of the composition content.

ID exclusivo para referência entre elementos

Conteúdo adicional definido por implementações

Extensões que não podem ser ignoradas mesmo que não sejam reconhecidas

Métodolo utilizada para autenticar a Composition: pessoal, profissional, legal, oficial

Indicates the level of authority of the attestation.

Quando a Composition foi atestada

Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).

Quem atestou a Composition

Identifies who has taken on the responsibility for accuracy of the composition content.

Identifica a organização ou grupo responsável pela composição.

This is useful when documents are derived from a composition - provides guidance for how to get the latest version of the document. This is optional because this is sometimes not known by the authoring system, and can be inferred by context. However, it is important that this information be known when working with a derived document, so providing a custodian is encouraged.

Identifies where to go to find the current version, where to report issues, etc.

Relações que esta composição tem com outras composições ou recursos.

A document is a version specific composition.

Relacionamentos com outras composições/Documents

Conteúdo adicional definido por implementações

Extensões que não podem ser ignoradas mesmo que não sejam reconhecidas

Alvo do relacionamento da composição

If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.

Relacionamento alvo

Referencia a composition alvo

O serviço especializado como uma colonoscopia ou uma apendicectomia, sendo documentado.

The event needs to be consistent with the type element, though can provide further information if desired.

Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event.

Identificador único para o elemento dentro de um recurso (para referências internas). Este pode ser qualquer valor de string que não contenha espaços.

Conteúdo adicional definido por implementações

Extensões que não podem ser ignoradas mesmo que não sejam reconhecidas

Esta lista de códigos representa os principais atos clínicos, como uma colonoscopia ou uma apendicectomia, sendo documentados. Em alguns casos, o evento é inerente ao typeCode, como um 'Histórico e Relatório Físico', no qual o procedimento documentado é necessariamente um ato de 'Histórico e Físico'.

An event can further specialize the act inherent in the typeCode, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more eventCodes are included, they SHALL NOT conflict with the values inherent in the classCode, practiceSettingCode or typeCode, as such a conflict would create an ambiguous situation. This short list of codes is provided to be used as key words for certain types of queries.

O período de tempo coberto pela composition. Não há afirmação de que a documentação seja uma representação completa para este período, apenas que documenta eventos durante esse tempo.

Referência aos eventos da Composition

A secção inicial da composition a partir da qual as demais seções são definidas

Identificador exclusivo para referência entre elementos

Conteúdo adicional definido por implementações

Extensões que não podem ser ignoradas mesmo que não sejam reconhecidas

Título da seção do Sumário Internacional do Paciente

The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

Um código que identifica o tipo de conteúdo contido dentro da seção. Isso deve ser consistente com o título da seção.

The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

Provides computable standardized labels to topics within the document.

Identifica quem é responsável pelas informações nesta seção, não necessariamente quem a digitou.

Identifies who is responsible for the content.

Quem/o que é a seção

Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

Resumo em texto livre da seção

Document profiles may define what content should be represented in the narrative to ensure clinical safety.

Método de processamento da seção

This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

Especifica a ordem dos itens nas sections.entry

Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

Uma referência ao recurso a partir do qual narrativa da seção é derivada.

If there are no entries in the list, an emptyReason SHOULD be provided.

Explicação porquê a secção está vazia

The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

If a section is empty, why it is empty.

Allows capturing things like "none exist" or "not asked" which can be important for most lists.

Uma subseção aninhada dentro desta seção

Nested sections are primarily used to help human readers navigate to particular portions of the document.

ID lógico deste artefato

ID lógico deste artefato

Conjunto de regras utilizadas para a elaboração deste conteúdo

Idioma do conteúdo do recurso

Resumo do recurso para interpretação humana

Recursos contidos neste artefato

Extensões que não podem ser ignoradas

Identificador independente da versão da Composition

Status/Situação da Composition: preliminar, definitivo, alterado, inserido com erro

Tipo da Composition (fixo em 'Sumário Internacional do Paciente)

ID exclusivo para referência entre elementos

Conteúdo adicional definido por implementações

Código definido por uma terminologia

ID exclusivo para referência entre elementos

Conteúdo adicional definido por implementações

Identidficador do sistema de terminologia.

Versão da terminologia LOINC - se relevante

Código conforme terminologia.

Descrição conforme definição da terminologia LOINC

Se esta codificação foi escolhida diretamente pelo usuário

Representação em texto livre do conceito

Categorização da Composition

Sobre quem e/ou sobre o que é a Composition

ID exclusivo para referência entre elementos

Conteúdo adicional definido por implementações

Referência literal, URL relativa, interna ou absoluta

Tipo ao qual a referência se refere (por exemplo,'Paciente')

Referência lógica, quando a referência literal não é conhecida

Texto alternativo para o recurso

Contato assistencial descrito nesta Composition

Data de edição da Composition

Quem e/ou o que foi o autor desta Compositon

Sumário Internacional do Paciente

Códigos que especificam o nível de confidencialidade da Composition

Responsável por atestar a acurácia da Composition

ID exclusivo para referência entre elementos

Conteúdo adicional definido por implementações

Extensões que não podem ser ignoradas mesmo que não sejam reconhecidas

Métodolo utilizada para autenticar a Composition: pessoal, profissional, legal, oficial

Quando a Composition foi atestada

Quem atestou a Composition

Identifica a organização ou grupo responsável pela composição.

Relações que esta composição tem com outras composições ou recursos.

Relacionamentos com outras composições/Documents

Conteúdo adicional definido por implementações

Extensões que não podem ser ignoradas mesmo que não sejam reconhecidas

Alvo do relacionamento da composição

Relacionamento alvo

Referencia a composition alvo

O serviço especializado como uma colonoscopia ou uma apendicectomia, sendo documentado.

Identificador único para o elemento dentro de um recurso (para referências internas). Este pode ser qualquer valor de string que não contenha espaços.

Conteúdo adicional definido por implementações

Extensões que não podem ser ignoradas mesmo que não sejam reconhecidas

Esta lista de códigos representa os principais atos clínicos, como uma colonoscopia ou uma apendicectomia, sendo documentados. Em alguns casos, o evento é inerente ao typeCode, como um 'Histórico e Relatório Físico', no qual o procedimento documentado é necessariamente um ato de 'Histórico e Físico'.

O período de tempo coberto pela composition. Não há afirmação de que a documentação seja uma representação completa para este período, apenas que documenta eventos durante esse tempo.

Referência aos eventos da Composition

A secção inicial da composition a partir da qual as demais seções são definidas

Identificador exclusivo para referência entre elementos

Conteúdo adicional definido por implementações

Extensões que não podem ser ignoradas mesmo que não sejam reconhecidas

Título da seção do Sumário Internacional do Paciente

Um código que identifica o tipo de conteúdo contido dentro da seção. Isso deve ser consistente com o título da seção.

Identifica quem é responsável pelas informações nesta seção, não necessariamente quem a digitou.

Quem/o que é a seção

Resumo em texto livre da seção

Método de processamento da seção

Especifica a ordem dos itens nas sections.entry

Uma referência ao recurso a partir do qual narrativa da seção é derivada.

Explicação porquê a secção está vazia

Uma subseção aninhada dentro desta seção

A set of healthcare-related information that is assembled together into a single logical package that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. A Composition defines the structure and narrative content necessary for a document. However, a Composition alone does not constitute a document. Rather, the Composition must be the first entry in a Bundle where Bundle.type=document, and any other resources referenced from Composition must be included as subsequent entries in the Bundle (for example Patient, Practitioner, Encounter, etc.).

While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical.

ID lógico deste artefato

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

ID lógico deste artefato

Conjunto de regras utilizadas para a elaboração deste conteúdo

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Idioma do conteúdo do recurso

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

A human language.

Resumo do recurso para interpretação humana

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Recursos contidos neste artefato

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Extensões que não podem ser ignoradas

Identificador independente da versão da Composition

Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate.

Status/Situação da Composition: preliminar, definitivo, alterado, inserido com erro

If a composition is marked as withdrawn, the compositions/documents in the series, or data from the composition or document series, should never be displayed to a user without being clearly marked as untrustworthy. The flag "entered-in-error" is why this element is labeled as a modifier of other elements.

Some reporting work flows require that the original narrative of a final document never be altered; instead, only new narrative can be added. The composition resource has no explicit status for explicitly noting whether this business rule is in effect. This would be handled by an extension if required.

Need to be able to mark interim, amended, or withdrawn compositions or documents.

Tipo da Composition (fixo em 'Sumário Internacional do Paciente)

For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation guides will require a specific LOINC code, or use LOINC as an extensible binding.

Key metadata element describing the composition, used in searching/filtering.

ID exclusivo para referência entre elementos

Conteúdo adicional definido por implementações

Código definido por uma terminologia

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.

Allows for alternative encodings within a code system, and translations to other code systems.

ID exclusivo para referência entre elementos

Conteúdo adicional definido por implementações

Identidficador do sistema de terminologia.

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 reference to some definition that establishes the system clearly and unambiguously.

Need to be unambiguous about the source of the definition of the symbol.

Versão da terminologia LOINC - se relevante

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.

Código conforme terminologia.

Need to refer to a particular code in the system.

Descrição conforme definição da terminologia LOINC

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Se esta codificação foi escolhida diretamente pelo usuário

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.

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.

Representação em texto livre do conceito

Very often the text is the same as a displayName of one of the codings.

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Categorização da Composition

This is a metadata field from XDS/MHD.

Helps humans to assess whether the composition is of interest when viewing an index of compositions or documents.

Sobre quem e/ou sobre o que é a Composition

For clinical documents, this is usually the patient.

Essential metadata for searching for the composition. Identifies who and/or what the composition/document is about.

ID exclusivo para referência entre elementos

Conteúdo adicional definido por implementações

Referência literal, URL relativa, interna ou absoluta

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.

Tipo ao qual a referência se refere (por exemplo,'Paciente')

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 RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Aa resource (or, for logical models, the URI of the logical model).

Referência lógica, quando a referência literal não é conhecida

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).

Texto alternativo para o recurso

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.

Contato assistencial descrito nesta Composition

Provides context for the composition and supports searching.

Data de edição da Composition

The Last Modified Date on the composition may be after the date of the document was attested without being changed.

dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring. When packaged in a document, Bundle.timestamp is the date of packaging.

Quem e/ou o que foi o autor desta Compositon

Identifies who is responsible for the content.

Sumário Internacional do Paciente

For many compositions, the title is the same as the text or a display name of Composition.type (e.g. a "consultation" or "progress note"). Note that CDA does not make title mandatory, but there are no known cases where it is useful for title to be omitted, so it is mandatory here. Feedback on this requirement is welcome during the trial use period.

Códigos que especificam o nível de confidencialidade da Composition

The exact use of this element, and enforcement and issues related to highly sensitive documents are out of scope for the base specification, and delegated to implementation profiles (see security section). This element is labeled as a modifier because highly confidential documents must not be treated as if they are not.

Responsável por atestar a acurácia da Composition

Only list each attester once.

Identifies responsibility for the accuracy of the composition content.

ID exclusivo para referência entre elementos

Conteúdo adicional definido por implementações

Extensões que não podem ser ignoradas mesmo que não sejam reconhecidas

Métodolo utilizada para autenticar a Composition: pessoal, profissional, legal, oficial

Indicates the level of authority of the attestation.

Quando a Composition foi atestada

Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).

Quem atestou a Composition

Identifies who has taken on the responsibility for accuracy of the composition content.

Identifica a organização ou grupo responsável pela composição.

This is useful when documents are derived from a composition - provides guidance for how to get the latest version of the document. This is optional because this is sometimes not known by the authoring system, and can be inferred by context. However, it is important that this information be known when working with a derived document, so providing a custodian is encouraged.

Identifies where to go to find the current version, where to report issues, etc.

Relações que esta composição tem com outras composições ou recursos.

A document is a version specific composition.

Relacionamentos com outras composições/Documents

Conteúdo adicional definido por implementações

Extensões que não podem ser ignoradas mesmo que não sejam reconhecidas

Alvo do relacionamento da composição

If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.

Relacionamento alvo

Referencia a composition alvo

O serviço especializado como uma colonoscopia ou uma apendicectomia, sendo documentado.