Guia de Implementação do Registro de Imunobiológico Administrado (RIA) da RNDS
0.1.0 - STU1 BR

!!Guia de Implementação do Registro de Imunobiológico Administrado (RIA) da RNDS - Compilação de desenvolvimento local (v0.1.0) construída pelas ferramentas de compilação FHIR (HL7® FHIR® Standard). Veja o Diretório de versões publicadas

Resource Profile: BRRegistroImunobiologicoAdministradoRotina - Detailed Descriptions

Page standards status: Informative Maturity Level: 1

Definitions for the BRRegistroImunobiologicoAdministradoRotina-2.0 resource profile.

Instruções sobre como interpretar o conteúdo desta tabela podem ser encontradashere

0. Composition
Definição

Documento que aprepresenta o registro da administração de imunobiológicos na rotina de imunização.

CurtoRegistro de Imunobiológico Administrado
Deve apoiartrue
Nomes alternativosRotina, Rotina vacinal, Imunobiológico
2. Composition.identifier
NotaTrata-se de um identificador de empresa e não de um identificador de recurso (ver discussão)
Controlo0..0
4. Composition.status
Curtofinal | entered-in-error
VínculoOs códigos DEVERÃO ser retirados de CompositionStatus
(required to http://hl7.org/fhir/ValueSet/composition-status|4.0.1)

Estado do documento

Deve apoiartrue
6. Composition.type
Definição

Especifica o tipo de documento que está sendo enviado na composição.

CurtoTipo de documento
VínculoOs códigos DEVERÃO ser retirados de Tipo de Documento
(preferred to http://www.saude.gov.br/fhir/r4/ValueSet/BRTipoDocumento-1.0)

Tipo de documento

Deve apoiartrue
8. Composition.type.coding
Controlo1..1
Deve apoiartrue
10. Composition.type.text
Controlo0..0
12. Composition.category
Definição

Classifica os contatos assistenciais de acordo com as especificidades do modo, local e duração do atendimento.

CurtoModalidade Assistencial
Controlo0..0
Deve apoiartrue
16. Composition.subject
Definição

Informações do indivíduo imunizado

CurtoIdentificação do paciente
Controlo1..?
TipoReference(http://www.saude.gov.br/fhir/r4/StructureDefinition/BRIndividuo-1.0)
Deve apoiartrue
18. Composition.subject.reference
Controlo0..0
20. Composition.subject.type
Controlo0..0
22. Composition.subject.identifier
Definição

Identificação unívoca dos usuários das ações e serviços de saúde, mediante número único válido em todo o território nacional. Poderão ser utilizados para essa identificação o Cartão Nacional de Saúde (CNS) válido ou Cadastro de Pessoa Física (CPF).

CurtoIdentificador Nacional do Indivíduo
NotaTrata-se de um identificador de empresa e não de um identificador de recurso (ver discussão)
Controlo1..?
24. Composition.subject.identifier.use
Controlo0..0
26. Composition.subject.identifier.type
Controlo0..0
28. Composition.subject.identifier.system
Controlo1..?
30. Composition.subject.identifier.value
Controlo1..?
32. Composition.subject.identifier.period
Controlo0..0
34. Composition.subject.identifier.assigner
Controlo0..0
36. Composition.subject.display
Controlo0..0
38. Composition.encounter
Controlo0..0
40. Composition.date
Definição

Data e hora em que o registro da vacinação foi registrado no sistema de origem. O padrão da data deve seguir a ISO8601.

CurtoData e hora do registro no sistema de origem
Deve apoiartrue
42. Composition.author
Definição

Identificação única do estabelecimento de saúde, por meio do Cadastro Nacional de Estabelecimentos de Saúde (CNES).

CurtoEstabelecimento de Saúde
Controlo0..1
TipoReference(http://www.saude.gov.br/fhir/r4/StructureDefinition/BREstabelecimentoSaude-1.0)
Deve apoiartrue
44. Composition.author.reference
Controlo0..0
46. Composition.author.type
Controlo0..0
48. Composition.author.identifier
CurtoCódigo CNES do Estabelecimento de Saúde.
NotaTrata-se de um identificador de empresa e não de um identificador de recurso (ver discussão)
Controlo1..?
50. Composition.author.identifier.use
Controlo0..0
52. Composition.author.identifier.type
Controlo0..0
54. Composition.author.identifier.system
Controlo1..?
56. Composition.author.identifier.value
Controlo1..?
58. Composition.author.identifier.period
Controlo0..0
60. Composition.author.identifier.assigner
Controlo0..0
62. Composition.author.display
Controlo0..0
64. Composition.title
Definição

Título do documento em linguagem humana.

CurtoTítulo do documento
Deve apoiartrue
Valor fixoRegistro de Imunobiologico Administrado na Rotina
66. Composition.confidentiality
Controlo0..0
68. Composition.attester
Controlo0..0
70. Composition.custodian
Controlo0..0
72. Composition.relatesTo
Definição

Indica uma relação entre esse documento e outro documento (ou composição) existente.

CurtoRelação a outros documentos
Controlo0..1
74. Composition.event
Controlo0..0
76. Composition.section
Definição

Referencia todas as seções (profiles/resources) contidos neste documento.

CurtoSeções do documento
Controlo1..1
Deve apoiartrue
78. Composition.section.title
Controlo0..0
80. Composition.section.code
Controlo0..0
82. Composition.section.author
Controlo0..0
84. Composition.section.focus
Controlo0..0
86. Composition.section.text
Controlo0..0
88. Composition.section.mode
Controlo0..0
90. Composition.section.orderedBy
Controlo0..0
92. Composition.section.entry
Definição

Representa o imunobiológico administrado.

CurtoRegistro de imunização
Controlo1..1
TipoReference(Imunobiológico Administrado em Rotina)
Deve apoiartrue
94. Composition.section.entry.reference
Controlo1..?
Deve apoiartrue
96. Composition.section.entry.type
Controlo0..0
98. Composition.section.entry.identifier
NotaTrata-se de um identificador de empresa e não de um identificador de recurso (ver discussão)
Controlo0..0
100. Composition.section.entry.display
Controlo0..0
102. Composition.section.emptyReason
Controlo0..0
104. Composition.section.section
Controlo0..0

Instruções sobre como interpretar o conteúdo desta tabela podem ser encontradashere

0. Composition
Definição

Documento que aprepresenta o registro da administração de imunobiológicos na rotina de imunização.


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.).

CurtoRegistro de Imunobiológico AdministradoA set of resources composed into a single coherent clinical statement with clinical attestation
Comentários

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.

Controlo0..*
É modificadorfalse
Deve apoiartrue
Resumofalse
Nomes alternativosRotina, Rotina vacinal, Imunobiológico
Invariantesdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. Composition.implicitRules
Definição

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

CurtoA set of rules under which this content was created
Comentários

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.

Controlo0..1
Tipouri
É modificadortrue porque This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Composition.modifierExtension
Definição

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

CurtoExtensions that cannot be ignored
Comentários

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.

Controlo0..*
TipoExtension
É modificadortrue porque Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Resumofalse
Requisitos

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Nomes alternativosextensions, user content
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. Composition.identifier
Definição

A version-independent identifier for the Composition. This identifier stays constant as the composition is changed over time.

CurtoVersion-independent identifier for the Composition
Comentários

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

NotaTrata-se de um identificador de empresa e não de um identificador de recurso (ver discussão)
Controlo0..01
TipoIdentifier
É modificadorfalse
Resumotrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. Composition.status
Definição

The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.

Curtofinal | entered-in-errorpreliminary | final | amended | entered-in-error
Comentários

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.

Controlo1..1
VínculoOs códigos DEVERÃO ser retirados de CompositionStatushttp://hl7.org/fhir/ValueSet/composition-status|4.0.1
(required to http://hl7.org/fhir/ValueSet/composition-status|4.0.1)

Estado do documento


The workflow/clinical status of the composition.

Tipocode
É modificadortrue porque This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Deve apoiartrue
Resumotrue
Requisitos

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

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. Composition.type
Definição

Especifica o tipo de documento que está sendo enviado na composição.


Specifies the particular kind of composition (e.g. History and Physical, Discharge Summary, Progress Note). This usually equates to the purpose of making the composition.

CurtoTipo de documentoKind of composition (LOINC if possible)
Comentários

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.

Controlo1..1
VínculoOs códigos DEVERÃO ser retirados de Tipo de Documentohttp://hl7.org/fhir/ValueSet/doc-typecodes
(preferred to http://www.saude.gov.br/fhir/r4/ValueSet/BRTipoDocumento-1.0)

Tipo de documento


Type of a composition.

TipoCodeableConcept
É modificadorfalse
Deve apoiartrue
Resumotrue
Requisitos

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

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. Composition.type.coding
Definição

A reference to a code defined by a terminology system.

CurtoCode defined by a terminology system
Comentários

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.

Controlo10..1*
TipoCoding
É modificadorfalse
Deve apoiartrue
Resumotrue
Requisitos

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

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. Composition.type.text
Definição

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

CurtoPlain text representation of the concept
Comentários

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

Controlo0..01
Tipostring
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Requisitos

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.

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. Composition.category
Definição

Classifica os contatos assistenciais de acordo com as especificidades do modo, local e duração do atendimento.


A categorization for the type of the composition - helps for indexing and searching. This may be implied by or derived from the code specified in the Composition Type.

CurtoModalidade AssistencialCategorization of Composition
Comentários

This is a metadata field from XDS/MHD.

Controlo0..0*
VínculoPara exemplos de códigos, ver DocumentClassValueSethttp://hl7.org/fhir/ValueSet/document-classcodes
(example to http://hl7.org/fhir/ValueSet/document-classcodes)

High-level kind of a clinical document at a macro level.

TipoCodeableConcept
É modificadorfalse
Deve apoiartrue
Resumotrue
Requisitos

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

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. Composition.subject
Definição

Informações do indivíduo imunizado


Who or what the composition is about. The composition can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure).

CurtoIdentificação do pacienteWho and/or what the composition is about
Comentários

For clinical documents, this is usually the patient.

Controlo10..1
TipoReference(http://www.saude.gov.br/fhir/r4/StructureDefinition/BRIndividuo-1.0, Resource)
É modificadorfalse
Deve apoiartrue
Resumotrue
Requisitos

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

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. Composition.subject.reference
Definição

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.

CurtoLiteral reference, Relative, internal or absolute URL
Comentários

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.

Controlo0..01
Este elemento é afetado pelas seguintes invariantes: ref-1
Tipostring
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. Composition.subject.type
Definição

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

CurtoType the reference refers to (e.g. "Patient")
Comentários

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.

Controlo0..01
VínculoA menos que não sejam adequados, estes códigos DEVERÃO ser retirados de ResourceTypehttp://hl7.org/fhir/ValueSet/resource-types
(extensible to http://hl7.org/fhir/ValueSet/resource-types)

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

Tipouri
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. Composition.subject.identifier
Definição

Identificação unívoca dos usuários das ações e serviços de saúde, mediante número único válido em todo o território nacional. Poderão ser utilizados para essa identificação o Cartão Nacional de Saúde (CNS) válido ou Cadastro de Pessoa Física (CPF).


An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

CurtoIdentificador Nacional do IndivíduoLogical reference, when literal reference is not known
Comentários

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).

NotaTrata-se de um identificador de empresa e não de um identificador de recurso (ver discussão)
Controlo10..1
TipoIdentifier
É modificadorfalse
Resumotrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. Composition.subject.identifier.use
Definição

The purpose of this identifier.

Curtousual | official | temp | secondary | old (If known)
Comentários

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Controlo0..01
VínculoOs códigos DEVERÃO ser retirados de IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
(required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

Identifies the purpose for this identifier, if known .

Tipocode
É modificadortrue porque This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Requisitos

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. Composition.subject.identifier.type
Definição

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

CurtoDescription of identifier
Comentários

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.

Controlo0..01
VínculoA menos que não sejam adequados, estes códigos DEVERÃO ser retirados de Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type
(extensible to http://hl7.org/fhir/ValueSet/identifier-type)

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

TipoCodeableConcept
É modificadorfalse
Resumotrue
Requisitos

Allows users to make use of identifiers when the identifier system is not known.

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. Composition.subject.identifier.system
Definição

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

CurtoThe namespace for the identifier value
Comentários

Identifier.system is always case sensitive.

Controlo10..1
Tipouri
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Requisitos

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.

Exemplo<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. Composition.subject.identifier.value
Definição

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

CurtoThe value that is unique
Comentários

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. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Controlo10..1
Tipostring
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Exemplo<br/><b>General</b>:123456
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. Composition.subject.identifier.period
Definição

Time period during which identifier is/was valid for use.

CurtoTime period when id is/was valid for use
Controlo0..01
TipoPeriod
É modificadorfalse
Resumotrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. Composition.subject.identifier.assigner
Definição

Organization that issued/manages the identifier.

CurtoOrganization that issued id (may be just text)
Comentários

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.

Controlo0..01
TipoReference(Organization)
É modificadorfalse
Resumotrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. Composition.subject.display
Definição

Plain text narrative that identifies the resource in addition to the resource reference.

CurtoText alternative for the resource
Comentários

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.

Controlo0..01
Tipostring
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. Composition.encounter
Definição

Describes the clinical encounter or type of care this documentation is associated with.

CurtoContext of the Composition
Controlo0..01
TipoReference(Encounter)
É modificadorfalse
Resumotrue
Requisitos

Provides context for the composition and supports searching.

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. Composition.date
Definição

Data e hora em que o registro da vacinação foi registrado no sistema de origem. O padrão da data deve seguir a ISO8601.


The composition editing time, when the composition was last logically changed by the author.

CurtoData e hora do registro no sistema de origemComposition editing time
Comentários

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

Controlo1..1
TipodateTime
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Deve apoiartrue
Resumotrue
Requisitos

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.


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.

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
46. Composition.author
Definição

Identificação única do estabelecimento de saúde, por meio do Cadastro Nacional de Estabelecimentos de Saúde (CNES).


Identifies who is responsible for the information in the composition, not necessarily who typed it in.

CurtoEstabelecimento de SaúdeWho and/or what authored the composition
Controlo1..1*
TipoReference(http://www.saude.gov.br/fhir/r4/StructureDefinition/BREstabelecimentoSaude-1.0, Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
É modificadorfalse
Deve apoiartrue
Resumotrue
Requisitos

Identifies who is responsible for the content.

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
48. Composition.author.reference
Definição

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.

CurtoLiteral reference, Relative, internal or absolute URL
Comentários

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.

Controlo0..01
Este elemento é afetado pelas seguintes invariantes: ref-1
Tipostring
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. Composition.author.type
Definição

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

CurtoType the reference refers to (e.g. "Patient")
Comentários

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.

Controlo0..01
VínculoA menos que não sejam adequados, estes códigos DEVERÃO ser retirados de ResourceTypehttp://hl7.org/fhir/ValueSet/resource-types
(extensible to http://hl7.org/fhir/ValueSet/resource-types)

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

Tipouri
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
52. Composition.author.identifier
Definição

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

CurtoCódigo CNES do Estabelecimento de Saúde.Logical reference, when literal reference is not known
Comentários

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).

NotaTrata-se de um identificador de empresa e não de um identificador de recurso (ver discussão)
Controlo10..1
TipoIdentifier
É modificadorfalse
Resumotrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
54. Composition.author.identifier.use
Definição

The purpose of this identifier.

Curtousual | official | temp | secondary | old (If known)
Comentários

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Controlo0..01
VínculoOs códigos DEVERÃO ser retirados de IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
(required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

Identifies the purpose for this identifier, if known .

Tipocode
É modificadortrue porque This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Requisitos

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
56. Composition.author.identifier.type
Definição

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

CurtoDescription of identifier
Comentários

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.

Controlo0..01
VínculoA menos que não sejam adequados, estes códigos DEVERÃO ser retirados de Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type
(extensible to http://hl7.org/fhir/ValueSet/identifier-type)

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

TipoCodeableConcept
É modificadorfalse
Resumotrue
Requisitos

Allows users to make use of identifiers when the identifier system is not known.

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
58. Composition.author.identifier.system
Definição

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

CurtoThe namespace for the identifier value
Comentários

Identifier.system is always case sensitive.

Controlo10..1
Tipouri
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Requisitos

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.

Exemplo<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
60. Composition.author.identifier.value
Definição

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

CurtoThe value that is unique
Comentários

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. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Controlo10..1
Tipostring
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Exemplo<br/><b>General</b>:123456
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
62. Composition.author.identifier.period
Definição

Time period during which identifier is/was valid for use.

CurtoTime period when id is/was valid for use
Controlo0..01
TipoPeriod
É modificadorfalse
Resumotrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
64. Composition.author.identifier.assigner
Definição

Organization that issued/manages the identifier.

CurtoOrganization that issued id (may be just text)
Comentários

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.

Controlo0..01
TipoReference(Organization)
É modificadorfalse
Resumotrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
66. Composition.author.display
Definição

Plain text narrative that identifies the resource in addition to the resource reference.

CurtoText alternative for the resource
Comentários

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.

Controlo0..01
Tipostring
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
68. Composition.title
Definição

Título do documento em linguagem humana.


Official human-readable label for the composition.

CurtoTítulo do documentoHuman Readable name/title
Comentários

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.

Controlo1..1
Tipostring
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Deve apoiartrue
Resumotrue
Valor fixoRegistro de Imunobiologico Administrado na Rotina
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
70. Composition.confidentiality
Definição

The code specifying the level of confidentiality of the Composition.

CurtoAs defined by affinity domain
Comentários

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.

Controlo0..01
VínculoOs códigos DEVERÃO ser retirados de v3.ConfidentialityClassification (2014-03-26)http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26
(required to http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26)

Codes specifying the level of confidentiality of the composition.

Tipocode
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
72. Composition.attester
Definição

A participant who has attested to the accuracy of the composition/document.

CurtoAttests to accuracy of composition
Comentários

Only list each attester once.

Controlo0..0*
TipoBackboneElement
É modificadorfalse
Resumofalse
Requisitos

Identifies responsibility for the accuracy of the composition content.

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
76. Composition.custodian
Definição

Identifies the organization or group who is responsible for ongoing maintenance of and access to the composition/document information.

CurtoOrganization which maintains the composition
Comentários

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.

Controlo0..01
TipoReference(Organization)
É modificadorfalse
Resumotrue
Requisitos

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

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
78. Composition.relatesTo
Definição

Indica uma relação entre esse documento e outro documento (ou composição) existente.


Relationships that this composition has with other compositions or documents that already exist.

CurtoRelação a outros documentosRelationships to other compositions/documents
Comentários

A document is a version specific composition.

Controlo0..1*
TipoBackboneElement
É modificadorfalse
Resumofalse
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
80. Composition.relatesTo.modifierExtension
Definição

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

CurtoExtensions that cannot be ignored even if unrecognized
Comentários

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.

Controlo0..*
TipoExtension
É modificadortrue porque Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Resumotrue
Requisitos

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Nomes alternativosextensions, user content, modifiers
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
82. Composition.relatesTo.code
Definição

The type of relationship that this composition has with anther composition or document.

Curtoreplaces | transforms | signs | appends
Comentários

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

Controlo1..1
VínculoOs códigos DEVERÃO ser retirados de DocumentRelationshipTypehttp://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1
(required to http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1)

The type of relationship between documents.

Tipocode
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumofalse
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
84. Composition.relatesTo.target[x]
Definição

The target composition/document of this relationship.

CurtoTarget of the relationship
Controlo1..1
TipoEscolha de: Identifier, Reference(Composition)
[x] NotaVerEscolha de tipos de dadospara mais informações sobre como utilizar [x]
É modificadorfalse
Resumofalse
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
86. Composition.event
Definição

The clinical service, such as a colonoscopy or an appendectomy, being documented.

CurtoThe clinical service(s) being documented
Comentários

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

Controlo0..0*
TipoBackboneElement
É modificadorfalse
Resumotrue
Requisitos

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

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
89. Composition.section
Definição

Referencia todas as seções (profiles/resources) contidos neste documento.


The root of the sections that make up the composition.

CurtoSeções do documentoComposition is broken into sections
Controlo10..1*
TipoBackboneElement
É modificadorfalse
Deve apoiartrue
Resumofalse
Invariantescmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
91. Composition.section.modifierExtension
Definição

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

CurtoExtensions that cannot be ignored even if unrecognized
Comentários

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.

Controlo0..*
TipoExtension
É modificadortrue porque Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Resumotrue
Requisitos

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Nomes alternativosextensions, user content, modifiers
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
93. Composition.section.title
Definição

The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

CurtoLabel for section (e.g. for ToC)
Comentários

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.

Controlo0..01
Tipostring
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumofalse
Requisitos

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

Nomes alternativosheader, label, caption
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
95. Composition.section.code
Definição

A code identifying the kind of content contained within the section. This must be consistent with the section title.

CurtoClassification of section (recommended)
Comentários

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.

Controlo0..01
VínculoPara exemplos de códigos, ver DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
(example to http://hl7.org/fhir/ValueSet/doc-section-codes)

Classification of a section of a composition/document.

TipoCodeableConcept
É modificadorfalse
Resumofalse
Requisitos

Provides computable standardized labels to topics within the document.

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
97. Composition.section.author
Definição

Identifies who is responsible for the information in this section, not necessarily who typed it in.

CurtoWho and/or what authored the section
Controlo0..0*
TipoReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
É modificadorfalse
Resumofalse
Requisitos

Identifies who is responsible for the content.

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
99. Composition.section.focus
Definição

The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

CurtoWho/what the section is about, when it is not about the subject of composition
Comentários

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.

Controlo0..01
TipoReference(Resource)
É modificadorfalse
Resumofalse
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
101. Composition.section.text
Definição

A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

CurtoText summary of the section, for human interpretation
Comentários

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

Controlo0..01
Este elemento é afetado pelas seguintes invariantes: cmp-1
TipoNarrative
É modificadorfalse
Resumofalse
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
103. Composition.section.mode
Definição

How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

Curtoworking | snapshot | changes
Comentários

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

Controlo0..01
VínculoOs códigos DEVERÃO ser retirados de ListModehttp://hl7.org/fhir/ValueSet/list-mode|4.0.1
(required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

The processing mode that applies to this section.

Tipocode
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumofalse
Requisitos

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

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
105. Composition.section.orderedBy
Definição

Specifies the order applied to the items in the section entries.

CurtoOrder of section entries
Comentários

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.

Controlo0..01
VínculoOs códigos DEVERÃO ser retirados de ListOrderCodeshttp://hl7.org/fhir/ValueSet/list-order
(preferred to http://hl7.org/fhir/ValueSet/list-order)

What order applies to the items in the entry.

TipoCodeableConcept
É modificadorfalse
Resumofalse
Requisitos

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

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
107. Composition.section.entry
Definição

Representa o imunobiológico administrado.


A reference to the actual resource from which the narrative in the section is derived.

CurtoRegistro de imunizaçãoA reference to data that supports this section
Comentários

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

Controlo10..1*
Este elemento é afetado pelas seguintes invariantes: cmp-2
TipoReference(Imunobiológico Administrado em Rotina, Resource)
É modificadorfalse
Deve apoiartrue
Resumofalse
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
109. Composition.section.entry.reference
Definição

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.

CurtoLiteral reference, Relative, internal or absolute URL
Comentários

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.

Controlo10..1
Este elemento é afetado pelas seguintes invariantes: ref-1
Tipostring
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Deve apoiartrue
Resumotrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
111. Composition.section.entry.type
Definição

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

CurtoType the reference refers to (e.g. "Patient")
Comentários

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.

Controlo0..01
VínculoA menos que não sejam adequados, estes códigos DEVERÃO ser retirados de ResourceTypehttp://hl7.org/fhir/ValueSet/resource-types
(extensible to http://hl7.org/fhir/ValueSet/resource-types)

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

Tipouri
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
113. Composition.section.entry.identifier
Definição

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

CurtoLogical reference, when literal reference is not known
Comentários

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).

NotaTrata-se de um identificador de empresa e não de um identificador de recurso (ver discussão)
Controlo0..01
TipoIdentifier
É modificadorfalse
Resumotrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
115. Composition.section.entry.display
Definição

Plain text narrative that identifies the resource in addition to the resource reference.

CurtoText alternative for the resource
Comentários

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.

Controlo0..01
Tipostring
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
117. Composition.section.emptyReason
Definição

If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

CurtoWhy the section is empty
Comentários

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.

Controlo0..01
Este elemento é afetado pelas seguintes invariantes: cmp-2
VínculoOs códigos DEVERÃO ser retirados de ListEmptyReasonshttp://hl7.org/fhir/ValueSet/list-empty-reason
(preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

If a section is empty, why it is empty.

TipoCodeableConcept
É modificadorfalse
Resumofalse
Requisitos

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

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
119. Composition.section.section
Definição

A nested sub-section within this section.

CurtoNested Section
Comentários

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

Controlo0..0*
Este elemento é afetado pelas seguintes invariantes: cmp-1
TipoVerttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
É modificadorfalse
Resumofalse
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

Instruções sobre como interpretar o conteúdo desta tabela podem ser encontradashere

0. Composition
Definição

Documento que aprepresenta o registro da administração de imunobiológicos na rotina de imunização.

CurtoRegistro de Imunobiológico Administrado
Comentários

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.

Controlo0..*
É modificadorfalse
Deve apoiartrue
Resumofalse
Nomes alternativosRotina, Rotina vacinal, Imunobiológico
Invariantesdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. Composition.id
Definição

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

CurtoLogical id of this artifact
Comentários

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

Controlo0..1
Tipoid
É modificadorfalse
Resumotrue
4. Composition.meta
Definição

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

CurtoMetadata about the resource
Controlo0..1
TipoMeta
É modificadorfalse
Resumotrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. Composition.implicitRules
Definição

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

CurtoA set of rules under which this content was created
Comentários

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.

Controlo0..1
Tipouri
É modificadortrue porque This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. Composition.language
Definição

The base language in which the resource is written.

CurtoLanguage of the resource content
Comentários

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).

Controlo0..1
VínculoOs códigos DEVERÃO ser retirados de CommonLanguages
(preferred to http://hl7.org/fhir/ValueSet/languages)

A human language.

Vínculos adicionaisObjetivo
AllLanguagesVínculo máximo
Tipocode
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumofalse
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. Composition.text
Definição

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

CurtoText summary of the resource, for human interpretation
Comentários

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.

Controlo0..1
TipoNarrative
É modificadorfalse
Resumofalse
Nomes alternativosnarrative, html, xhtml, display
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. Composition.contained
Definição

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

CurtoContained, inline Resources
Comentários

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.

Controlo0..*
TipoResource
É modificadorfalse
Resumofalse
Nomes alternativosinline resources, anonymous resources, contained resources
14. Composition.extension
Definição

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.

CurtoAdditional content defined by implementations
Comentários

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.

Controlo0..*
TipoExtension
É modificadorfalse
Resumofalse
Nomes alternativosextensions, user content
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
16. Composition.modifierExtension
Definição

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

CurtoExtensions that cannot be ignored
Comentários

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.

Controlo0..*
TipoExtension
É modificadortrue porque Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Resumofalse
Requisitos

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Nomes alternativosextensions, user content
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
18. Composition.identifier
Definição

A version-independent identifier for the Composition. This identifier stays constant as the composition is changed over time.

CurtoVersion-independent identifier for the Composition
Comentários

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

NotaTrata-se de um identificador de empresa e não de um identificador de recurso (ver discussão)
Controlo0..0
TipoIdentifier
É modificadorfalse
Resumotrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. Composition.status
Definição

The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.

Curtofinal | entered-in-error
Comentários

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.

Controlo1..1
VínculoOs códigos DEVERÃO ser retirados de CompositionStatus
(required to http://hl7.org/fhir/ValueSet/composition-status|4.0.1)

Estado do documento

Tipocode
É modificadortrue porque This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Deve apoiartrue
Resumotrue
Requisitos

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

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. Composition.type
Definição

Especifica o tipo de documento que está sendo enviado na composição.

CurtoTipo de documento
Comentários

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.

Controlo1..1
VínculoOs códigos DEVERÃO ser retirados de Tipo de Documento
(preferred to http://www.saude.gov.br/fhir/r4/ValueSet/BRTipoDocumento-1.0)

Tipo de documento

TipoCodeableConcept
É modificadorfalse
Deve apoiartrue
Resumotrue
Requisitos

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

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. Composition.type.id
Definição

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

CurtoUnique id for inter-element referencing
Controlo0..1
Tipostring
É modificadorfalse
Formato XMLNo formato XML, esta propriedade é representada como um atributo.
Resumofalse
26. Composition.type.extension
Definição

May be used to represent additional information that is not part of the basic definition of the element. 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.

CurtoAdditional content defined by implementations
Comentários

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.

Controlo0..*
TipoExtension
É modificadorfalse
Resumofalse
Nomes alternativosextensions, user content
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingEste elemento introduz um conjunto de fatias em Composition.type.extension. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
  • value @ url
  • 28. Composition.type.coding
    Definição

    A reference to a code defined by a terminology system.

    CurtoCode defined by a terminology system
    Comentários

    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.

    Controlo1..1
    TipoCoding
    É modificadorfalse
    Deve apoiartrue
    Resumotrue
    Requisitos

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

    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    30. Composition.type.text
    Definição

    A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

    CurtoPlain text representation of the concept
    Comentários

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

    Controlo0..0
    Tipostring
    É modificadorfalse
    Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
    Resumotrue
    Requisitos

    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.

    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    32. Composition.category
    Definição

    Classifica os contatos assistenciais de acordo com as especificidades do modo, local e duração do atendimento.

    CurtoModalidade Assistencial
    Comentários

    This is a metadata field from XDS/MHD.

    Controlo0..0
    VínculoPara exemplos de códigos, ver DocumentClassValueSet
    (example to http://hl7.org/fhir/ValueSet/document-classcodes)

    High-level kind of a clinical document at a macro level.

    TipoCodeableConcept
    É modificadorfalse
    Deve apoiartrue
    Resumotrue
    Requisitos

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

    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    38. Composition.subject
    Definição

    Informações do indivíduo imunizado

    CurtoIdentificação do paciente
    Comentários

    For clinical documents, this is usually the patient.

    Controlo1..1
    TipoReference(http://www.saude.gov.br/fhir/r4/StructureDefinition/BRIndividuo-1.0)
    É modificadorfalse
    Deve apoiartrue
    Resumotrue
    Requisitos

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

    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    40. Composition.subject.id
    Definição

    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

    CurtoUnique id for inter-element referencing
    Controlo0..1
    Tipostring
    É modificadorfalse
    Formato XMLNo formato XML, esta propriedade é representada como um atributo.
    Resumofalse
    42. Composition.subject.extension
    Definição

    May be used to represent additional information that is not part of the basic definition of the element. 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.

    CurtoAdditional content defined by implementations
    Comentários

    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.

    Controlo0..*
    TipoExtension
    É modificadorfalse
    Resumofalse
    Nomes alternativosextensions, user content
    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingEste elemento introduz um conjunto de fatias em Composition.subject.extension. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
    • value @ url
    • 44. Composition.subject.reference
      Definição

      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.

      CurtoLiteral reference, Relative, internal or absolute URL
      Comentários

      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.

      Controlo0..0
      Este elemento é afetado pelas seguintes invariantes: ref-1
      Tipostring
      É modificadorfalse
      Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
      Resumotrue
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      46. Composition.subject.type
      Definição

      The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

      The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

      CurtoType the reference refers to (e.g. "Patient")
      Comentários

      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.

      Controlo0..0
      VínculoA menos que não sejam adequados, estes códigos DEVERÃO ser retirados de ResourceType
      (extensible to http://hl7.org/fhir/ValueSet/resource-types)

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

      Tipouri
      É modificadorfalse
      Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
      Resumotrue
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      48. Composition.subject.identifier
      Definição

      Identificação unívoca dos usuários das ações e serviços de saúde, mediante número único válido em todo o território nacional. Poderão ser utilizados para essa identificação o Cartão Nacional de Saúde (CNS) válido ou Cadastro de Pessoa Física (CPF).

      CurtoIdentificador Nacional do Indivíduo
      Comentários

      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).

      NotaTrata-se de um identificador de empresa e não de um identificador de recurso (ver discussão)
      Controlo1..1
      TipoIdentifier
      É modificadorfalse
      Resumotrue
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      50. Composition.subject.identifier.id
      Definição

      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

      CurtoUnique id for inter-element referencing
      Controlo0..1
      Tipostring
      É modificadorfalse
      Formato XMLNo formato XML, esta propriedade é representada como um atributo.
      Resumofalse
      52. Composition.subject.identifier.extension
      Definição

      May be used to represent additional information that is not part of the basic definition of the element. 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.

      CurtoAdditional content defined by implementations
      Comentários

      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.

      Controlo0..*
      TipoExtension
      É modificadorfalse
      Resumofalse
      Nomes alternativosextensions, user content
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingEste elemento introduz um conjunto de fatias em Composition.subject.identifier.extension. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
      • value @ url
      • 54. Composition.subject.identifier.use
        Definição

        The purpose of this identifier.

        Curtousual | official | temp | secondary | old (If known)
        Comentários

        Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

        Controlo0..0
        VínculoOs códigos DEVERÃO ser retirados de IdentifierUse
        (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

        Identifies the purpose for this identifier, if known .

        Tipocode
        É modificadortrue porque This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
        Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
        Resumotrue
        Requisitos

        Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        56. Composition.subject.identifier.type
        Definição

        A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

        CurtoDescription of identifier
        Comentários

        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.

        Controlo0..0
        VínculoA menos que não sejam adequados, estes códigos DEVERÃO ser retirados de Identifier Type Codes
        (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

        A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

        TipoCodeableConcept
        É modificadorfalse
        Resumotrue
        Requisitos

        Allows users to make use of identifiers when the identifier system is not known.

        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        58. Composition.subject.identifier.system
        Definição

        Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

        CurtoThe namespace for the identifier value
        Comentários

        Identifier.system is always case sensitive.

        Controlo1..1
        Tipouri
        É modificadorfalse
        Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
        Resumotrue
        Requisitos

        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.

        Exemplo<br/><b>General</b>:http://www.acme.com/identifiers/patient
        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        60. Composition.subject.identifier.value
        Definição

        The portion of the identifier typically relevant to the user and which is unique within the context of the system.

        CurtoThe value that is unique
        Comentários

        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. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

        Controlo1..1
        Tipostring
        É modificadorfalse
        Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
        Resumotrue
        Exemplo<br/><b>General</b>:123456
        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        62. Composition.subject.identifier.period
        Definição

        Time period during which identifier is/was valid for use.

        CurtoTime period when id is/was valid for use
        Controlo0..0
        TipoPeriod
        É modificadorfalse
        Resumotrue
        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        64. Composition.subject.identifier.assigner
        Definição

        Organization that issued/manages the identifier.

        CurtoOrganization that issued id (may be just text)
        Comentários

        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.

        Controlo0..0
        TipoReference(Organization)
        É modificadorfalse
        Resumotrue
        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        66. Composition.subject.display
        Definição

        Plain text narrative that identifies the resource in addition to the resource reference.

        CurtoText alternative for the resource
        Comentários

        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.

        Controlo0..0
        Tipostring
        É modificadorfalse
        Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
        Resumotrue
        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        68. Composition.encounter
        Definição

        Describes the clinical encounter or type of care this documentation is associated with.

        CurtoContext of the Composition
        Controlo0..0
        TipoReference(Encounter)
        É modificadorfalse
        Resumotrue
        Requisitos

        Provides context for the composition and supports searching.

        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        70. Composition.date
        Definição

        Data e hora em que o registro da vacinação foi registrado no sistema de origem. O padrão da data deve seguir a ISO8601.

        CurtoData e hora do registro no sistema de origem
        Comentários

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

        Controlo1..1
        TipodateTime
        É modificadorfalse
        Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
        Deve apoiartrue
        Resumotrue
        Requisitos

        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.

        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        72. Composition.author
        Definição

        Identificação única do estabelecimento de saúde, por meio do Cadastro Nacional de Estabelecimentos de Saúde (CNES).

        CurtoEstabelecimento de Saúde
        Controlo1..1
        TipoReference(http://www.saude.gov.br/fhir/r4/StructureDefinition/BREstabelecimentoSaude-1.0)
        É modificadorfalse
        Deve apoiartrue
        Resumotrue
        Requisitos

        Identifies who is responsible for the content.

        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        74. Composition.author.id
        Definição

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        CurtoUnique id for inter-element referencing
        Controlo0..1
        Tipostring
        É modificadorfalse
        Formato XMLNo formato XML, esta propriedade é representada como um atributo.
        Resumofalse
        76. Composition.author.extension
        Definição

        May be used to represent additional information that is not part of the basic definition of the element. 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.

        CurtoAdditional content defined by implementations
        Comentários

        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.

        Controlo0..*
        TipoExtension
        É modificadorfalse
        Resumofalse
        Nomes alternativosextensions, user content
        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingEste elemento introduz um conjunto de fatias em Composition.author.extension. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
        • value @ url
        • 78. Composition.author.reference
          Definição

          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.

          CurtoLiteral reference, Relative, internal or absolute URL
          Comentários

          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.

          Controlo0..0
          Este elemento é afetado pelas seguintes invariantes: ref-1
          Tipostring
          É modificadorfalse
          Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
          Resumotrue
          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          80. Composition.author.type
          Definição

          The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

          The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

          CurtoType the reference refers to (e.g. "Patient")
          Comentários

          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.

          Controlo0..0
          VínculoA menos que não sejam adequados, estes códigos DEVERÃO ser retirados de ResourceType
          (extensible to http://hl7.org/fhir/ValueSet/resource-types)

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

          Tipouri
          É modificadorfalse
          Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
          Resumotrue
          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          82. Composition.author.identifier
          Definição

          An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

          CurtoCódigo CNES do Estabelecimento de Saúde.
          Comentários

          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).

          NotaTrata-se de um identificador de empresa e não de um identificador de recurso (ver discussão)
          Controlo1..1
          TipoIdentifier
          É modificadorfalse
          Resumotrue
          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          84. Composition.author.identifier.id
          Definição

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          CurtoUnique id for inter-element referencing
          Controlo0..1
          Tipostring
          É modificadorfalse
          Formato XMLNo formato XML, esta propriedade é representada como um atributo.
          Resumofalse
          86. Composition.author.identifier.extension
          Definição

          May be used to represent additional information that is not part of the basic definition of the element. 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.

          CurtoAdditional content defined by implementations
          Comentários

          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.

          Controlo0..*
          TipoExtension
          É modificadorfalse
          Resumofalse
          Nomes alternativosextensions, user content
          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingEste elemento introduz um conjunto de fatias em Composition.author.identifier.extension. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
          • value @ url
          • 88. Composition.author.identifier.use
            Definição

            The purpose of this identifier.

            Curtousual | official | temp | secondary | old (If known)
            Comentários

            Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

            Controlo0..0
            VínculoOs códigos DEVERÃO ser retirados de IdentifierUse
            (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

            Identifies the purpose for this identifier, if known .

            Tipocode
            É modificadortrue porque This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
            Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
            Resumotrue
            Requisitos

            Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            90. Composition.author.identifier.type
            Definição

            A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

            CurtoDescription of identifier
            Comentários

            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.

            Controlo0..0
            VínculoA menos que não sejam adequados, estes códigos DEVERÃO ser retirados de Identifier Type Codes
            (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

            A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

            TipoCodeableConcept
            É modificadorfalse
            Resumotrue
            Requisitos

            Allows users to make use of identifiers when the identifier system is not known.

            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            92. Composition.author.identifier.system
            Definição

            Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

            CurtoThe namespace for the identifier value
            Comentários

            Identifier.system is always case sensitive.

            Controlo1..1
            Tipouri
            É modificadorfalse
            Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
            Resumotrue
            Requisitos

            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.

            Exemplo<br/><b>General</b>:http://www.acme.com/identifiers/patient
            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            94. Composition.author.identifier.value
            Definição

            The portion of the identifier typically relevant to the user and which is unique within the context of the system.

            CurtoThe value that is unique
            Comentários

            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. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

            Controlo1..1
            Tipostring
            É modificadorfalse
            Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
            Resumotrue
            Exemplo<br/><b>General</b>:123456
            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            96. Composition.author.identifier.period
            Definição

            Time period during which identifier is/was valid for use.

            CurtoTime period when id is/was valid for use
            Controlo0..0
            TipoPeriod
            É modificadorfalse
            Resumotrue
            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            98. Composition.author.identifier.assigner
            Definição

            Organization that issued/manages the identifier.

            CurtoOrganization that issued id (may be just text)
            Comentários

            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.

            Controlo0..0
            TipoReference(Organization)
            É modificadorfalse
            Resumotrue
            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            100. Composition.author.display
            Definição

            Plain text narrative that identifies the resource in addition to the resource reference.

            CurtoText alternative for the resource
            Comentários

            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.

            Controlo0..0
            Tipostring
            É modificadorfalse
            Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
            Resumotrue
            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            102. Composition.title
            Definição

            Título do documento em linguagem humana.

            CurtoTítulo do documento
            Comentários

            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.

            Controlo1..1
            Tipostring
            É modificadorfalse
            Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
            Deve apoiartrue
            Resumotrue
            Valor fixoRegistro de Imunobiologico Administrado na Rotina
            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            104. Composition.confidentiality
            Definição

            The code specifying the level of confidentiality of the Composition.

            CurtoAs defined by affinity domain
            Comentários

            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.

            Controlo0..0
            VínculoOs códigos DEVERÃO ser retirados de v3.ConfidentialityClassification (2014-03-26)
            (required to http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26)

            Codes specifying the level of confidentiality of the composition.

            Tipocode
            É modificadorfalse
            Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
            Resumotrue
            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            106. Composition.attester
            Definição

            A participant who has attested to the accuracy of the composition/document.

            CurtoAttests to accuracy of composition
            Comentários

            Only list each attester once.

            Controlo0..0
            TipoBackboneElement
            É modificadorfalse
            Resumofalse
            Requisitos

            Identifies responsibility for the accuracy of the composition content.

            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            114. Composition.custodian
            Definição

            Identifies the organization or group who is responsible for ongoing maintenance of and access to the composition/document information.

            CurtoOrganization which maintains the composition
            Comentários

            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.

            Controlo0..0
            TipoReference(Organization)
            É modificadorfalse
            Resumotrue
            Requisitos

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

            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            116. Composition.relatesTo
            Definição

            Indica uma relação entre esse documento e outro documento (ou composição) existente.

            CurtoRelação a outros documentos
            Comentários

            A document is a version specific composition.

            Controlo0..1
            TipoBackboneElement
            É modificadorfalse
            Resumofalse
            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            118. Composition.relatesTo.id
            Definição

            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            CurtoUnique id for inter-element referencing
            Controlo0..1
            Tipostring
            É modificadorfalse
            Formato XMLNo formato XML, esta propriedade é representada como um atributo.
            Resumofalse
            120. Composition.relatesTo.extension
            Definição

            May be used to represent additional information that is not part of the basic definition of the element. 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.

            CurtoAdditional content defined by implementations
            Comentários

            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.

            Controlo0..*
            TipoExtension
            É modificadorfalse
            Resumofalse
            Nomes alternativosextensions, user content
            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            122. Composition.relatesTo.modifierExtension
            Definição

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            CurtoExtensions that cannot be ignored even if unrecognized
            Comentários

            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.

            Controlo0..*
            TipoExtension
            É modificadortrue porque Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Resumotrue
            Requisitos

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Nomes alternativosextensions, user content, modifiers
            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            124. Composition.relatesTo.code
            Definição

            The type of relationship that this composition has with anther composition or document.

            Curtoreplaces | transforms | signs | appends
            Comentários

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

            Controlo1..1
            VínculoOs códigos DEVERÃO ser retirados de DocumentRelationshipType
            (required to http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1)

            The type of relationship between documents.

            Tipocode
            É modificadorfalse
            Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
            Resumofalse
            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            126. Composition.relatesTo.target[x]
            Definição

            The target composition/document of this relationship.

            CurtoTarget of the relationship
            Controlo1..1
            TipoEscolha de: Identifier, Reference(Composition)
            [x] NotaVerEscolha de tipos de dadospara mais informações sobre como utilizar [x]
            É modificadorfalse
            Resumofalse
            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            128. Composition.event
            Definição

            The clinical service, such as a colonoscopy or an appendectomy, being documented.

            CurtoThe clinical service(s) being documented
            Comentários

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

            Controlo0..0
            TipoBackboneElement
            É modificadorfalse
            Resumotrue
            Requisitos

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

            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            136. Composition.section
            Definição

            Referencia todas as seções (profiles/resources) contidos neste documento.

            CurtoSeções do documento
            Controlo1..1
            TipoBackboneElement
            É modificadorfalse
            Deve apoiartrue
            Resumofalse
            Invariantescmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            138. Composition.section.id
            Definição

            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            CurtoUnique id for inter-element referencing
            Controlo0..1
            Tipostring
            É modificadorfalse
            Formato XMLNo formato XML, esta propriedade é representada como um atributo.
            Resumofalse
            140. Composition.section.extension
            Definição

            May be used to represent additional information that is not part of the basic definition of the element. 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.

            CurtoAdditional content defined by implementations
            Comentários

            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.

            Controlo0..*
            TipoExtension
            É modificadorfalse
            Resumofalse
            Nomes alternativosextensions, user content
            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            142. Composition.section.modifierExtension
            Definição

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            CurtoExtensions that cannot be ignored even if unrecognized
            Comentários

            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.

            Controlo0..*
            TipoExtension
            É modificadortrue porque Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Resumotrue
            Requisitos

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Nomes alternativosextensions, user content, modifiers
            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            144. Composition.section.title
            Definição

            The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

            CurtoLabel for section (e.g. for ToC)
            Comentários

            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.

            Controlo0..0
            Tipostring
            É modificadorfalse
            Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
            Resumofalse
            Requisitos

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

            Nomes alternativosheader, label, caption
            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            146. Composition.section.code
            Definição

            A code identifying the kind of content contained within the section. This must be consistent with the section title.

            CurtoClassification of section (recommended)
            Comentários

            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.

            Controlo0..0
            VínculoPara exemplos de códigos, ver DocumentSectionCodes
            (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

            Classification of a section of a composition/document.

            TipoCodeableConcept
            É modificadorfalse
            Resumofalse
            Requisitos

            Provides computable standardized labels to topics within the document.

            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            148. Composition.section.author
            Definição

            Identifies who is responsible for the information in this section, not necessarily who typed it in.

            CurtoWho and/or what authored the section
            Controlo0..0
            TipoReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
            É modificadorfalse
            Resumofalse
            Requisitos

            Identifies who is responsible for the content.

            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            150. Composition.section.focus
            Definição

            The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

            CurtoWho/what the section is about, when it is not about the subject of composition
            Comentários

            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.

            Controlo0..0
            TipoReference(Resource)
            É modificadorfalse
            Resumofalse
            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            152. Composition.section.text
            Definição

            A human-readable narrative that contains the attested content of the section, used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative.

            CurtoText summary of the section, for human interpretation
            Comentários

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

            Controlo0..0
            Este elemento é afetado pelas seguintes invariantes: cmp-1
            TipoNarrative
            É modificadorfalse
            Resumofalse
            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            154. Composition.section.mode
            Definição

            How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

            Curtoworking | snapshot | changes
            Comentários

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

            Controlo0..0
            VínculoOs códigos DEVERÃO ser retirados de ListMode
            (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

            The processing mode that applies to this section.

            Tipocode
            É modificadorfalse
            Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
            Resumofalse
            Requisitos

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

            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            156. Composition.section.orderedBy
            Definição

            Specifies the order applied to the items in the section entries.

            CurtoOrder of section entries
            Comentários

            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.

            Controlo0..0
            VínculoOs códigos DEVERÃO ser retirados de ListOrderCodes
            (preferred to http://hl7.org/fhir/ValueSet/list-order)

            What order applies to the items in the entry.

            TipoCodeableConcept
            É modificadorfalse
            Resumofalse
            Requisitos

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

            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            158. Composition.section.entry
            Definição

            Representa o imunobiológico administrado.

            CurtoRegistro de imunização
            Comentários

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

            Controlo1..1
            Este elemento é afetado pelas seguintes invariantes: cmp-2
            TipoReference(Imunobiológico Administrado em Rotina)
            É modificadorfalse
            Deve apoiartrue
            Resumofalse
            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            160. Composition.section.entry.id
            Definição

            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            CurtoUnique id for inter-element referencing
            Controlo0..1
            Tipostring
            É modificadorfalse
            Formato XMLNo formato XML, esta propriedade é representada como um atributo.
            Resumofalse
            162. Composition.section.entry.extension
            Definição

            May be used to represent additional information that is not part of the basic definition of the element. 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.

            CurtoAdditional content defined by implementations
            Comentários

            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.

            Controlo0..*
            TipoExtension
            É modificadorfalse
            Resumofalse
            Nomes alternativosextensions, user content
            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingEste elemento introduz um conjunto de fatias em Composition.section.entry.extension. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
            • value @ url
            • 164. Composition.section.entry.reference
              Definição

              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.

              CurtoLiteral reference, Relative, internal or absolute URL
              Comentários

              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.

              Controlo1..1
              Este elemento é afetado pelas seguintes invariantes: ref-1
              Tipostring
              É modificadorfalse
              Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
              Deve apoiartrue
              Resumotrue
              Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              166. Composition.section.entry.type
              Definição

              The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

              The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

              CurtoType the reference refers to (e.g. "Patient")
              Comentários

              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.

              Controlo0..0
              VínculoA menos que não sejam adequados, estes códigos DEVERÃO ser retirados de ResourceType
              (extensible to http://hl7.org/fhir/ValueSet/resource-types)

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

              Tipouri
              É modificadorfalse
              Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
              Resumotrue
              Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              168. Composition.section.entry.identifier
              Definição

              An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

              CurtoLogical reference, when literal reference is not known
              Comentários

              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).

              NotaTrata-se de um identificador de empresa e não de um identificador de recurso (ver discussão)
              Controlo0..0
              TipoIdentifier
              É modificadorfalse
              Resumotrue
              Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              170. Composition.section.entry.display
              Definição

              Plain text narrative that identifies the resource in addition to the resource reference.

              CurtoText alternative for the resource
              Comentários

              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.

              Controlo0..0
              Tipostring
              É modificadorfalse
              Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
              Resumotrue
              Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              172. Composition.section.emptyReason
              Definição

              If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

              CurtoWhy the section is empty
              Comentários

              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.

              Controlo0..0
              Este elemento é afetado pelas seguintes invariantes: cmp-2
              VínculoOs códigos DEVERÃO ser retirados de ListEmptyReasons
              (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

              If a section is empty, why it is empty.

              TipoCodeableConcept
              É modificadorfalse
              Resumofalse
              Requisitos

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

              Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              174. Composition.section.section
              Definição

              A nested sub-section within this section.

              CurtoNested Section
              Comentários

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

              Controlo0..0
              Este elemento é afetado pelas seguintes invariantes: cmp-1
              TipoVerttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
              É modificadorfalse
              Resumofalse
              Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))