Scope and usage

The MedComDocumentComposition profile defines the structure and narrative content necessary for a document. However, a Composition alone does not constitute a document - the Composition must be the first entry in a Bundle where Bundle.type = document. Any other resources referenced from Composition must be included as subsequent entries in the Bundle.

The Composition resource organizes clinical and administrative content into sections, each of which contains a narrative, and references other resources for supporting data.

Several elements in this profile map directly to IHE XDS DocumentEntry metadata to ensure compatibility with existing national and international document exchange infrastructures.

Author institution and author person

The author element allows up to two references and must always include exactly one author organization and optionally one author person.

Author institution: The slice author:institution is mandatory and restricts the reference to a MedComDocumentOrganization. This ensures that every document has one clear author organization responsible for its creation.

Author person: An additional author element that does not match the institutional slice is interpreted as an author person. If used, it MUST reference exactly one resource of the allowed types: MedComDocumentPractitioner, MedComDocumentPractitionerRole, MedComDocumentPatient, DkCoreRelatedPerson, or Device.

Mapping from IHE-XDS metadata to FHIR Composition

MedCom has developed a mapping. Find the mapping from IHE XDS metadata to FHIR Composition here.

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

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Composition		0..*	Composition	A set of resources composed into a single coherent clinical statement with clinical attestation
id	SOΣ	1..1	id	Logical id of this artifact Obligations Actor SHALL:in-narrative Producer of FHIR resources
meta	SΣ	1..1	Meta	Metadata about the resource
profile	SOΣC	1..1	canonical(StructureDefinition)	[DocumentEntry.formatCode] Indicates the FHIR Composition profile canonical, including an explicit version `|x.y.z`. The value does not map 1:1 to XDS DocumentEntry.formatCode and SHALL be mapped. Constraints: medcom-canonical-semver Obligations Actor SHALL:in-narrative Producer of FHIR resources
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language	SO	1..1	code	[DocumentEntry.languageCode] Human language of the content Binding: IHE LanguageCode_TEMP (extensible) Obligations Actor SHALL:in-narrative Producer of FHIR resources
text	S	1..1	Narrative	The narrative text SHALL always be included when exchanging a MedCom FHIR Bundle. This profile does not constrain the narrative in regard to content, language, or traceability to data elements
status	S	1..1	code	generated | extensions | additional | empty Binding: NarrativeStatus (required): The status of a resource narrative.
div	SC	1..1	xhtml	Limited xhtml content Constraints: txt-1, txt-2
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..1	Identifier	The Composition identifier
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	1..1	uri	[DocumentEntry.uniqueId] Sender organization OID (Object Identifier). Example: 1.2.208.184 (MedCom OID). Example General: http://www.acme.com/identifiers/patient
value	SΣC	1..1	string	[DocumentEntry.uniqueId] UUID. Constraints: medcom-uuid Example General: 123456
status	?!SOΣ	1..1	code	preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): The workflow/clinical status of the composition. Required Pattern: final Obligations Actor SHALL:in-narrative Producer of FHIR resources
type	SΣ	1..1	CodeableConcept	[DocumentEntry.typeCode] Kind of document Binding: IHE TypeCode_TEMP (required)
coding	SΣ	1..1	Coding	Code defined by a terminology system
system	SOΣ	1..1	uri	Identity of the terminology system Obligations Actor SHALL:in-narrative Producer of FHIR resources
code	SOΣ	1..1	code	Symbol in syntax defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
display	SOΣ	1..1	string	Representation defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
category	SΣ	0..1	CodeableConcept	[DocumentEntry.classCode] Categorization of document Binding: IHE ClassCode_TEMP (extensible)
coding	SΣ	1..1	Coding	Code defined by a terminology system
system	SOΣ	1..1	uri	Identity of the terminology system Obligations Actor SHALL:in-narrative Producer of FHIR resources
code	SOΣ	1..1	code	Symbol in syntax defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
display	SOΣ	1..1	string	Representation defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
subject	SOΣ	1..1	Reference(MedComDocumentPatient) {b}	Who and/or what the composition is about Obligations Actor SHALL:in-narrative Producer of FHIR resources
date	SOΣ	1..1	dateTime	Composition editing time Obligations Actor SHALL:in-narrative Producer of FHIR resources
Slices for author	SOΣ	1..2	Reference(MedComDocumentOrganization | MedComDocumentPractitionerRole | MedComDocumentPractitioner | MedComDocumentPatient | Danish Core Related Person Profile | Device) {b}	[DocumentEntry.author] The slice author:institution ensures one mandatory organizational author. Any author element that does not match this slice is interpreted as an author person. Slice: Unordered, Open by profile:$this.resolve() Obligations Actor SHALL:in-narrative Producer of FHIR resources
author:institution	SOΣ	1..1	Reference(MedComDocumentOrganization)	The organization who authored the document. Obligations Actor SHALL:in-narrative Producer of FHIR resources
title	SOΣ	1..1	string	[DocumentEntry.title] The readable title of the document. Obligations Actor SHALL:in-narrative Producer of FHIR resources
confidentiality	SOΣ	1..1	code	As defined by affinity domain Binding: v3.ConfidentialityClassification (2014-03-26) (required): Codes specifying the level of confidentiality of the composition. Obligations Actor SHALL:in-narrative Producer of FHIR resources
attester	S	0..1	BackboneElement	Attests to accuracy of composition
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode	SO	1..1	code	personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. Obligations Actor SHALL:in-narrative Producer of FHIR resources
party	SO	0..1	Reference(MedComDocumentPractitioner) {b}	[DocumentEntry.legalAuthenticator] Who authenticated the document. Obligations Actor SHALL:in-narrative Producer of FHIR resources
event	SΣ	1..1	BackboneElement	The clinical service(s) being documented
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SOΣ	0..*	CodeableConcept	Code(s) that apply to the event being documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented. Obligations Actor SHALL:in-narrative Producer of FHIR resources
period	SΣ	1..1	Period	[DocumentEntry.serviceStartTime, DocumentEntry.serviceStopTime] Time of service that is being documented.
start	SOΣC	1..1	dateTime	Starting time with inclusive boundary Obligations Actor SHALL:in-narrative Producer of FHIR resources
end	SOΣC	0..1	dateTime	End time with inclusive boundary, if not ongoing Obligations Actor SHALL:in-narrative Producer of FHIR resources
detail	SOΣ	0..*	Reference(Resource)	[DocumentEntry.referenceIdList] Related identifiers or resources Obligations Actor SHALL:in-narrative Producer of FHIR resources
section	SC	1..*	BackboneElement	Composition is broken into sections Constraints: cmp-1, cmp-2
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
entry	SOC	0..*	Reference(Resource)	A reference to data that supports this section Obligations Actor SHALL:in-narrative Producer of FHIR resources
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Composition.language	extensible	MedComIHE_CoreLanguageCode_TEMP http://medcomfhir.dk/ig/document/ValueSet/MedCom-ihe-core-languagecode-VS-TEMP From this IG
Composition.text.status	required	NarrativeStatus http://hl7.org/fhir/ValueSet/narrative-status|4.0.1 From the FHIR Standard
Composition.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
Composition.status	required	Pattern Value: final http://hl7.org/fhir/ValueSet/composition-status|4.0.1 From the FHIR Standard
Composition.type	required	MedComIHE_CoreTypeCode_TEMP http://medcomfhir.dk/ig/document/ValueSet/MedCom-ihe-core-typecode-VS-TEMP From this IG
Composition.category	extensible	MedComIHE_CoreClassCode_TEMP http://medcomfhir.dk/ig/document/ValueSet/MedCom-ihe-core-classcode-VS-TEMP From this IG
Composition.confidentiality	required	v3.ConfidentialityClassification http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26 From the FHIR Standard
Composition.attester.mode	required	CompositionAttestationMode http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1 From the FHIR Standard
Composition.event.code	example	ActCode http://terminology.hl7.org/ValueSet/v3-ActCode

Constraints

Id	Grade	Path(s)	Details	Requirements
cmp-1	error	Composition.section	A section must contain at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists()
cmp-2	error	Composition.section	A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty()
dom-2	error	Composition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Composition	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	error	Composition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Composition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Composition	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
medcom-canonical-semver	error	Composition.meta.profile	The canonical SHALL include an explicit semantic version (semver) with optional prerelease (-...) and build metadata (+...). : matches('^.*[|][0-9]+[.][0-9]+([.][0-9]+)?(-[0-9A-Za-z-]+([.][0-9A-Za-z-]+)*)?([+][0-9A-Za-z-]+([.][0-9A-Za-z-]+)*)?$')
medcom-uuid	error	Composition.identifier.value	The value shall correspond to the structure of an UUID : $this.matches('(?i)^urn:uuid:[0-9a-f]{8}-[0-9a-f]{4}-[45][0-9a-f]{3}-[89ab][0-9a-f]{3}-[0-9a-f]{12}$')
txt-1	error	Composition.text.div	The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes : htmlChecks()
txt-2	error	Composition.text.div	The narrative SHALL have some non-whitespace content : htmlChecks()

This structure is derived from Composition

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Composition		0..*	Composition	A set of resources composed into a single coherent clinical statement with clinical attestation
id	SO	1..1	id	Logical id of this artifact Obligations Actor SHALL:in-narrative Producer of FHIR resources
meta	S	1..1	Meta	Metadata about the resource
profile	SOC	1..1	canonical(StructureDefinition)	[DocumentEntry.formatCode] Indicates the FHIR Composition profile canonical, including an explicit version `|x.y.z`. The value does not map 1:1 to XDS DocumentEntry.formatCode and SHALL be mapped. Constraints: medcom-canonical-semver Obligations Actor SHALL:in-narrative Producer of FHIR resources
language	SO	1..1	code	[DocumentEntry.languageCode] Human language of the content Binding: IHE LanguageCode_TEMP (extensible) Obligations Actor SHALL:in-narrative Producer of FHIR resources
text	S	1..1	Narrative	The narrative text SHALL always be included when exchanging a MedCom FHIR Bundle.
status	S	1..1	code	generated | extensions | additional | empty
div	S	1..1	xhtml	Limited xhtml content
identifier	S	1..1	Identifier	The Composition identifier
system	S	1..1	uri	[DocumentEntry.uniqueId] Sender organization OID (Object Identifier). Example: 1.2.208.184 (MedCom OID).
value	SC	1..1	string	[DocumentEntry.uniqueId] UUID. Constraints: medcom-uuid
status	SO	1..1	code	preliminary | final | amended | entered-in-error Required Pattern: final Obligations Actor SHALL:in-narrative Producer of FHIR resources
type	S	1..1	CodeableConcept	[DocumentEntry.typeCode] Kind of document Binding: IHE TypeCode_TEMP (required)
coding	S	1..1	Coding	Code defined by a terminology system
system	SO	1..1	uri	Identity of the terminology system Obligations Actor SHALL:in-narrative Producer of FHIR resources
code	SO	1..1	code	Symbol in syntax defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
display	SO	1..1	string	Representation defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
category	S	0..1	CodeableConcept	[DocumentEntry.classCode] Categorization of document Binding: IHE ClassCode_TEMP (extensible)
coding	S	1..1	Coding	Code defined by a terminology system
system	SO	1..1	uri	Identity of the terminology system Obligations Actor SHALL:in-narrative Producer of FHIR resources
code	SO	1..1	code	Symbol in syntax defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
display	SO	1..1	string	Representation defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
subject	SO	1..1	Reference(MedComDocumentPatient) {b}	Who and/or what the composition is about Obligations Actor SHALL:in-narrative Producer of FHIR resources
date	SO	1..1	dateTime	Composition editing time Obligations Actor SHALL:in-narrative Producer of FHIR resources
Slices for author	SO	1..2	Reference(MedComDocumentOrganization | MedComDocumentPractitionerRole | MedComDocumentPractitioner | MedComDocumentPatient | Danish Core Related Person Profile | Device) {b}	[DocumentEntry.author] The slice author:institution ensures one mandatory organizational author. Any author element that does not match this slice is interpreted as an author person. Slice: Unordered, Open by profile:$this.resolve() Obligations Actor SHALL:in-narrative Producer of FHIR resources
author:institution	SO	1..1	Reference(MedComDocumentOrganization)	The organization who authored the document. Obligations Actor SHALL:in-narrative Producer of FHIR resources
title	SO	1..1	string	[DocumentEntry.title] The readable title of the document. Obligations Actor SHALL:in-narrative Producer of FHIR resources
confidentiality	SO	1..1	code	As defined by affinity domain Obligations Actor SHALL:in-narrative Producer of FHIR resources
attester	S	0..1	BackboneElement	Attests to accuracy of composition
mode	SO	1..1	code	personal | professional | legal | official Obligations Actor SHALL:in-narrative Producer of FHIR resources
party	SO	0..1	Reference(MedComDocumentPractitioner) {b}	[DocumentEntry.legalAuthenticator] Who authenticated the document. Obligations Actor SHALL:in-narrative Producer of FHIR resources
event	S	1..1	BackboneElement	The clinical service(s) being documented
code	SO	0..*	CodeableConcept	Code(s) that apply to the event being documented Obligations Actor SHALL:in-narrative Producer of FHIR resources
period	S	1..1	Period	[DocumentEntry.serviceStartTime, DocumentEntry.serviceStopTime] Time of service that is being documented.
start	SO	1..1	dateTime	Starting time with inclusive boundary Obligations Actor SHALL:in-narrative Producer of FHIR resources
end	SO	0..1	dateTime	End time with inclusive boundary, if not ongoing Obligations Actor SHALL:in-narrative Producer of FHIR resources
detail	SO	0..*	Reference(Resource)	[DocumentEntry.referenceIdList] Related identifiers or resources Obligations Actor SHALL:in-narrative Producer of FHIR resources
section	S	1..*	BackboneElement	Composition is broken into sections
entry	SO	0..*	Reference(Resource)	A reference to data that supports this section Obligations Actor SHALL:in-narrative Producer of FHIR resources
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Composition.language	extensible	MedComIHE_CoreLanguageCode_TEMP http://medcomfhir.dk/ig/document/ValueSet/MedCom-ihe-core-languagecode-VS-TEMP From this IG
Composition.type	required	MedComIHE_CoreTypeCode_TEMP http://medcomfhir.dk/ig/document/ValueSet/MedCom-ihe-core-typecode-VS-TEMP From this IG
Composition.category	extensible	MedComIHE_CoreClassCode_TEMP http://medcomfhir.dk/ig/document/ValueSet/MedCom-ihe-core-classcode-VS-TEMP From this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
medcom-canonical-semver	error	Composition.meta.profile	The canonical SHALL include an explicit semantic version (semver) with optional prerelease (-...) and build metadata (+...). : matches('^.*[|][0-9]+[.][0-9]+([.][0-9]+)?(-[0-9A-Za-z-]+([.][0-9A-Za-z-]+)*)?([+][0-9A-Za-z-]+([.][0-9A-Za-z-]+)*)?$')
medcom-uuid	error	Composition.identifier.value	The value shall correspond to the structure of an UUID : $this.matches('(?i)^urn:uuid:[0-9a-f]{8}-[0-9a-f]{4}-[45][0-9a-f]{3}-[89ab][0-9a-f]{3}-[0-9a-f]{12}$')

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Composition		0..*	Composition	A set of resources composed into a single coherent clinical statement with clinical attestation
id	SOΣ	1..1	id	Logical id of this artifact Obligations Actor SHALL:in-narrative Producer of FHIR resources
meta	SΣ	1..1	Meta	Metadata about the resource
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
versionId	Σ	0..1	id	Version specific identifier
lastUpdated	Σ	0..1	instant	When the resource version last changed
source	Σ	0..1	uri	Identifies where the resource comes from
profile	SOΣC	1..1	canonical(StructureDefinition)	[DocumentEntry.formatCode] Indicates the FHIR Composition profile canonical, including an explicit version `|x.y.z`. The value does not map 1:1 to XDS DocumentEntry.formatCode and SHALL be mapped. Constraints: medcom-canonical-semver Obligations Actor SHALL:in-narrative Producer of FHIR resources
security	Σ	0..*	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag	Σ	0..*	Coding	Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language	SO	1..1	code	[DocumentEntry.languageCode] Human language of the content Binding: IHE LanguageCode_TEMP (extensible) Obligations Actor SHALL:in-narrative Producer of FHIR resources
text	S	1..1	Narrative	The narrative text SHALL always be included when exchanging a MedCom FHIR Bundle. This profile does not constrain the narrative in regard to content, language, or traceability to data elements
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
status	S	1..1	code	generated | extensions | additional | empty Binding: NarrativeStatus (required): The status of a resource narrative.
div	SC	1..1	xhtml	Limited xhtml content Constraints: txt-1, txt-2
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..1	Identifier	The Composition identifier
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	[DocumentEntry.uniqueId] Sender organization OID (Object Identifier). Example: 1.2.208.184 (MedCom OID). Example General: http://www.acme.com/identifiers/patient
value	SΣC	1..1	string	[DocumentEntry.uniqueId] UUID. Constraints: medcom-uuid Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!SOΣ	1..1	code	preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): The workflow/clinical status of the composition. Required Pattern: final Obligations Actor SHALL:in-narrative Producer of FHIR resources
type	SΣ	1..1	CodeableConcept	[DocumentEntry.typeCode] Kind of document Binding: IHE TypeCode_TEMP (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	1..1	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SOΣ	1..1	uri	Identity of the terminology system Obligations Actor SHALL:in-narrative Producer of FHIR resources
version	Σ	0..1	string	Version of the system - if relevant
code	SOΣ	1..1	code	Symbol in syntax defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
display	SOΣ	1..1	string	Representation defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
category	SΣ	0..1	CodeableConcept	[DocumentEntry.classCode] Categorization of document Binding: IHE ClassCode_TEMP (extensible)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	1..1	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SOΣ	1..1	uri	Identity of the terminology system Obligations Actor SHALL:in-narrative Producer of FHIR resources
version	Σ	0..1	string	Version of the system - if relevant
code	SOΣ	1..1	code	Symbol in syntax defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
display	SOΣ	1..1	string	Representation defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subject	SOΣ	1..1	Reference(MedComDocumentPatient) {b}	Who and/or what the composition is about Obligations Actor SHALL:in-narrative Producer of FHIR resources
encounter	Σ	0..1	Reference(Encounter)	Context of the Composition
date	SOΣ	1..1	dateTime	Composition editing time Obligations Actor SHALL:in-narrative Producer of FHIR resources
Slices for author	SOΣ	1..2	Reference(MedComDocumentOrganization | MedComDocumentPractitionerRole | MedComDocumentPractitioner | MedComDocumentPatient | Danish Core Related Person Profile | Device) {b}	[DocumentEntry.author] The slice author:institution ensures one mandatory organizational author. Any author element that does not match this slice is interpreted as an author person. Slice: Unordered, Open by profile:$this.resolve() Obligations Actor SHALL:in-narrative Producer of FHIR resources
author:institution	SOΣ	1..1	Reference(MedComDocumentOrganization)	The organization who authored the document. Obligations Actor SHALL:in-narrative Producer of FHIR resources
title	SOΣ	1..1	string	[DocumentEntry.title] The readable title of the document. Obligations Actor SHALL:in-narrative Producer of FHIR resources
confidentiality	SOΣ	1..1	code	As defined by affinity domain Binding: v3.ConfidentialityClassification (2014-03-26) (required): Codes specifying the level of confidentiality of the composition. Obligations Actor SHALL:in-narrative Producer of FHIR resources
attester	S	0..1	BackboneElement	Attests to accuracy of composition
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode	SO	1..1	code	personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. Obligations Actor SHALL:in-narrative Producer of FHIR resources
time		0..1	dateTime	When the composition was attested
party	SO	0..1	Reference(MedComDocumentPractitioner) {b}	[DocumentEntry.legalAuthenticator] Who authenticated the document. Obligations Actor SHALL:in-narrative Producer of FHIR resources
custodian	Σ	0..1	Reference(Organization)	Organization which maintains the composition
relatesTo		0..*	BackboneElement	Relationships to other compositions/documents
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	code	replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target[x]		1..1		Target of the relationship
targetIdentifier			Identifier
targetReference			Reference(Composition)
event	SΣ	1..1	BackboneElement	The clinical service(s) being documented
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SOΣ	0..*	CodeableConcept	Code(s) that apply to the event being documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented. Obligations Actor SHALL:in-narrative Producer of FHIR resources
period	SΣ	1..1	Period	[DocumentEntry.serviceStartTime, DocumentEntry.serviceStopTime] Time of service that is being documented.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	SOΣC	1..1	dateTime	Starting time with inclusive boundary Obligations Actor SHALL:in-narrative Producer of FHIR resources
end	SOΣC	0..1	dateTime	End time with inclusive boundary, if not ongoing Obligations Actor SHALL:in-narrative Producer of FHIR resources
detail	SOΣ	0..*	Reference(Resource)	[DocumentEntry.referenceIdList] Related identifiers or resources Obligations Actor SHALL:in-narrative Producer of FHIR resources
section	SC	1..*	BackboneElement	Composition is broken into sections Constraints: cmp-1, cmp-2
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title		0..1	string	Label for section (e.g. for ToC)
code		0..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	SOC	0..*	Reference(Resource)	A reference to data that supports this section Obligations Actor SHALL:in-narrative Producer of FHIR resources
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Composition.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels|4.0.1 From the FHIR Standard
Composition.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags|4.0.1 From the FHIR Standard
Composition.language	extensible	MedComIHE_CoreLanguageCode_TEMP http://medcomfhir.dk/ig/document/ValueSet/MedCom-ihe-core-languagecode-VS-TEMP From this IG
Composition.text.status	required	NarrativeStatus http://hl7.org/fhir/ValueSet/narrative-status|4.0.1 From the FHIR Standard
Composition.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
Composition.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type|4.0.1 From the FHIR Standard
Composition.status	required	Pattern Value: final http://hl7.org/fhir/ValueSet/composition-status|4.0.1 From the FHIR Standard
Composition.type	required	MedComIHE_CoreTypeCode_TEMP http://medcomfhir.dk/ig/document/ValueSet/MedCom-ihe-core-typecode-VS-TEMP From this IG
Composition.category	extensible	MedComIHE_CoreClassCode_TEMP http://medcomfhir.dk/ig/document/ValueSet/MedCom-ihe-core-classcode-VS-TEMP From this IG
Composition.confidentiality	required	v3.ConfidentialityClassification http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26 From the FHIR Standard
Composition.attester.mode	required	CompositionAttestationMode http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1 From the FHIR Standard
Composition.relatesTo.code	required	DocumentRelationshipType http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1 From the FHIR Standard
Composition.event.code	example	ActCode http://terminology.hl7.org/ValueSet/v3-ActCode
Composition.section.code	example	DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 From the FHIR Standard
Composition.section.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 From the FHIR Standard
Composition.section.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order|4.0.1 From the FHIR Standard
Composition.section.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cmp-1	error	Composition.section	A section must contain at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists()
cmp-2	error	Composition.section	A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty()
dom-2	error	Composition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Composition	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	error	Composition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Composition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Composition	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
medcom-canonical-semver	error	Composition.meta.profile	The canonical SHALL include an explicit semantic version (semver) with optional prerelease (-...) and build metadata (+...). : matches('^.*[|][0-9]+[.][0-9]+([.][0-9]+)?(-[0-9A-Za-z-]+([.][0-9A-Za-z-]+)*)?([+][0-9A-Za-z-]+([.][0-9A-Za-z-]+)*)?$')
medcom-uuid	error	Composition.identifier.value	The value shall correspond to the structure of an UUID : $this.matches('(?i)^urn:uuid:[0-9a-f]{8}-[0-9a-f]{4}-[45][0-9a-f]{3}-[89ab][0-9a-f]{3}-[0-9a-f]{12}$')
txt-1	error	Composition.text.div	The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes : htmlChecks()
txt-2	error	Composition.text.div	The narrative SHALL have some non-whitespace content : htmlChecks()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Composition		0..*	Composition	A set of resources composed into a single coherent clinical statement with clinical attestation
id	SOΣ	1..1	id	Logical id of this artifact Obligations Actor SHALL:in-narrative Producer of FHIR resources
meta	SΣ	1..1	Meta	Metadata about the resource
profile	SOΣC	1..1	canonical(StructureDefinition)	[DocumentEntry.formatCode] Indicates the FHIR Composition profile canonical, including an explicit version `|x.y.z`. The value does not map 1:1 to XDS DocumentEntry.formatCode and SHALL be mapped. Constraints: medcom-canonical-semver Obligations Actor SHALL:in-narrative Producer of FHIR resources
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language	SO	1..1	code	[DocumentEntry.languageCode] Human language of the content Binding: IHE LanguageCode_TEMP (extensible) Obligations Actor SHALL:in-narrative Producer of FHIR resources
text	S	1..1	Narrative	The narrative text SHALL always be included when exchanging a MedCom FHIR Bundle. This profile does not constrain the narrative in regard to content, language, or traceability to data elements
status	S	1..1	code	generated | extensions | additional | empty Binding: NarrativeStatus (required): The status of a resource narrative.
div	SC	1..1	xhtml	Limited xhtml content Constraints: txt-1, txt-2
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..1	Identifier	The Composition identifier
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	1..1	uri	[DocumentEntry.uniqueId] Sender organization OID (Object Identifier). Example: 1.2.208.184 (MedCom OID). Example General: http://www.acme.com/identifiers/patient
value	SΣC	1..1	string	[DocumentEntry.uniqueId] UUID. Constraints: medcom-uuid Example General: 123456
status	?!SOΣ	1..1	code	preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): The workflow/clinical status of the composition. Required Pattern: final Obligations Actor SHALL:in-narrative Producer of FHIR resources
type	SΣ	1..1	CodeableConcept	[DocumentEntry.typeCode] Kind of document Binding: IHE TypeCode_TEMP (required)
coding	SΣ	1..1	Coding	Code defined by a terminology system
system	SOΣ	1..1	uri	Identity of the terminology system Obligations Actor SHALL:in-narrative Producer of FHIR resources
code	SOΣ	1..1	code	Symbol in syntax defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
display	SOΣ	1..1	string	Representation defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
category	SΣ	0..1	CodeableConcept	[DocumentEntry.classCode] Categorization of document Binding: IHE ClassCode_TEMP (extensible)
coding	SΣ	1..1	Coding	Code defined by a terminology system
system	SOΣ	1..1	uri	Identity of the terminology system Obligations Actor SHALL:in-narrative Producer of FHIR resources
code	SOΣ	1..1	code	Symbol in syntax defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
display	SOΣ	1..1	string	Representation defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
subject	SOΣ	1..1	Reference(MedComDocumentPatient) {b}	Who and/or what the composition is about Obligations Actor SHALL:in-narrative Producer of FHIR resources
date	SOΣ	1..1	dateTime	Composition editing time Obligations Actor SHALL:in-narrative Producer of FHIR resources
Slices for author	SOΣ	1..2	Reference(MedComDocumentOrganization | MedComDocumentPractitionerRole | MedComDocumentPractitioner | MedComDocumentPatient | Danish Core Related Person Profile | Device) {b}	[DocumentEntry.author] The slice author:institution ensures one mandatory organizational author. Any author element that does not match this slice is interpreted as an author person. Slice: Unordered, Open by profile:$this.resolve() Obligations Actor SHALL:in-narrative Producer of FHIR resources
author:institution	SOΣ	1..1	Reference(MedComDocumentOrganization)	The organization who authored the document. Obligations Actor SHALL:in-narrative Producer of FHIR resources
title	SOΣ	1..1	string	[DocumentEntry.title] The readable title of the document. Obligations Actor SHALL:in-narrative Producer of FHIR resources
confidentiality	SOΣ	1..1	code	As defined by affinity domain Binding: v3.ConfidentialityClassification (2014-03-26) (required): Codes specifying the level of confidentiality of the composition. Obligations Actor SHALL:in-narrative Producer of FHIR resources
attester	S	0..1	BackboneElement	Attests to accuracy of composition
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode	SO	1..1	code	personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. Obligations Actor SHALL:in-narrative Producer of FHIR resources
party	SO	0..1	Reference(MedComDocumentPractitioner) {b}	[DocumentEntry.legalAuthenticator] Who authenticated the document. Obligations Actor SHALL:in-narrative Producer of FHIR resources
event	SΣ	1..1	BackboneElement	The clinical service(s) being documented
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SOΣ	0..*	CodeableConcept	Code(s) that apply to the event being documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented. Obligations Actor SHALL:in-narrative Producer of FHIR resources
period	SΣ	1..1	Period	[DocumentEntry.serviceStartTime, DocumentEntry.serviceStopTime] Time of service that is being documented.
start	SOΣC	1..1	dateTime	Starting time with inclusive boundary Obligations Actor SHALL:in-narrative Producer of FHIR resources
end	SOΣC	0..1	dateTime	End time with inclusive boundary, if not ongoing Obligations Actor SHALL:in-narrative Producer of FHIR resources
detail	SOΣ	0..*	Reference(Resource)	[DocumentEntry.referenceIdList] Related identifiers or resources Obligations Actor SHALL:in-narrative Producer of FHIR resources
section	SC	1..*	BackboneElement	Composition is broken into sections Constraints: cmp-1, cmp-2
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
entry	SOC	0..*	Reference(Resource)	A reference to data that supports this section Obligations Actor SHALL:in-narrative Producer of FHIR resources
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Composition.language	extensible	MedComIHE_CoreLanguageCode_TEMP http://medcomfhir.dk/ig/document/ValueSet/MedCom-ihe-core-languagecode-VS-TEMP From this IG
Composition.text.status	required	NarrativeStatus http://hl7.org/fhir/ValueSet/narrative-status|4.0.1 From the FHIR Standard
Composition.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
Composition.status	required	Pattern Value: final http://hl7.org/fhir/ValueSet/composition-status|4.0.1 From the FHIR Standard
Composition.type	required	MedComIHE_CoreTypeCode_TEMP http://medcomfhir.dk/ig/document/ValueSet/MedCom-ihe-core-typecode-VS-TEMP From this IG
Composition.category	extensible	MedComIHE_CoreClassCode_TEMP http://medcomfhir.dk/ig/document/ValueSet/MedCom-ihe-core-classcode-VS-TEMP From this IG
Composition.confidentiality	required	v3.ConfidentialityClassification http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26 From the FHIR Standard
Composition.attester.mode	required	CompositionAttestationMode http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1 From the FHIR Standard
Composition.event.code	example	ActCode http://terminology.hl7.org/ValueSet/v3-ActCode

Constraints

Id	Grade	Path(s)	Details	Requirements
cmp-1	error	Composition.section	A section must contain at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists()
cmp-2	error	Composition.section	A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty()
dom-2	error	Composition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Composition	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	error	Composition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Composition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Composition	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
medcom-canonical-semver	error	Composition.meta.profile	The canonical SHALL include an explicit semantic version (semver) with optional prerelease (-...) and build metadata (+...). : matches('^.*[|][0-9]+[.][0-9]+([.][0-9]+)?(-[0-9A-Za-z-]+([.][0-9A-Za-z-]+)*)?([+][0-9A-Za-z-]+([.][0-9A-Za-z-]+)*)?$')
medcom-uuid	error	Composition.identifier.value	The value shall correspond to the structure of an UUID : $this.matches('(?i)^urn:uuid:[0-9a-f]{8}-[0-9a-f]{4}-[45][0-9a-f]{3}-[89ab][0-9a-f]{3}-[0-9a-f]{12}$')
txt-1	error	Composition.text.div	The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes : htmlChecks()
txt-2	error	Composition.text.div	The narrative SHALL have some non-whitespace content : htmlChecks()

Differential View

This structure is derived from Composition

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Composition		0..*	Composition	A set of resources composed into a single coherent clinical statement with clinical attestation
id	SO	1..1	id	Logical id of this artifact Obligations Actor SHALL:in-narrative Producer of FHIR resources
meta	S	1..1	Meta	Metadata about the resource
profile	SOC	1..1	canonical(StructureDefinition)	[DocumentEntry.formatCode] Indicates the FHIR Composition profile canonical, including an explicit version `|x.y.z`. The value does not map 1:1 to XDS DocumentEntry.formatCode and SHALL be mapped. Constraints: medcom-canonical-semver Obligations Actor SHALL:in-narrative Producer of FHIR resources
language	SO	1..1	code	[DocumentEntry.languageCode] Human language of the content Binding: IHE LanguageCode_TEMP (extensible) Obligations Actor SHALL:in-narrative Producer of FHIR resources
text	S	1..1	Narrative	The narrative text SHALL always be included when exchanging a MedCom FHIR Bundle.
status	S	1..1	code	generated | extensions | additional | empty
div	S	1..1	xhtml	Limited xhtml content
identifier	S	1..1	Identifier	The Composition identifier
system	S	1..1	uri	[DocumentEntry.uniqueId] Sender organization OID (Object Identifier). Example: 1.2.208.184 (MedCom OID).
value	SC	1..1	string	[DocumentEntry.uniqueId] UUID. Constraints: medcom-uuid
status	SO	1..1	code	preliminary | final | amended | entered-in-error Required Pattern: final Obligations Actor SHALL:in-narrative Producer of FHIR resources
type	S	1..1	CodeableConcept	[DocumentEntry.typeCode] Kind of document Binding: IHE TypeCode_TEMP (required)
coding	S	1..1	Coding	Code defined by a terminology system
system	SO	1..1	uri	Identity of the terminology system Obligations Actor SHALL:in-narrative Producer of FHIR resources
code	SO	1..1	code	Symbol in syntax defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
display	SO	1..1	string	Representation defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
category	S	0..1	CodeableConcept	[DocumentEntry.classCode] Categorization of document Binding: IHE ClassCode_TEMP (extensible)
coding	S	1..1	Coding	Code defined by a terminology system
system	SO	1..1	uri	Identity of the terminology system Obligations Actor SHALL:in-narrative Producer of FHIR resources
code	SO	1..1	code	Symbol in syntax defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
display	SO	1..1	string	Representation defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
subject	SO	1..1	Reference(MedComDocumentPatient) {b}	Who and/or what the composition is about Obligations Actor SHALL:in-narrative Producer of FHIR resources
date	SO	1..1	dateTime	Composition editing time Obligations Actor SHALL:in-narrative Producer of FHIR resources
Slices for author	SO	1..2	Reference(MedComDocumentOrganization | MedComDocumentPractitionerRole | MedComDocumentPractitioner | MedComDocumentPatient | Danish Core Related Person Profile | Device) {b}	[DocumentEntry.author] The slice author:institution ensures one mandatory organizational author. Any author element that does not match this slice is interpreted as an author person. Slice: Unordered, Open by profile:$this.resolve() Obligations Actor SHALL:in-narrative Producer of FHIR resources
author:institution	SO	1..1	Reference(MedComDocumentOrganization)	The organization who authored the document. Obligations Actor SHALL:in-narrative Producer of FHIR resources
title	SO	1..1	string	[DocumentEntry.title] The readable title of the document. Obligations Actor SHALL:in-narrative Producer of FHIR resources
confidentiality	SO	1..1	code	As defined by affinity domain Obligations Actor SHALL:in-narrative Producer of FHIR resources
attester	S	0..1	BackboneElement	Attests to accuracy of composition
mode	SO	1..1	code	personal | professional | legal | official Obligations Actor SHALL:in-narrative Producer of FHIR resources
party	SO	0..1	Reference(MedComDocumentPractitioner) {b}	[DocumentEntry.legalAuthenticator] Who authenticated the document. Obligations Actor SHALL:in-narrative Producer of FHIR resources
event	S	1..1	BackboneElement	The clinical service(s) being documented
code	SO	0..*	CodeableConcept	Code(s) that apply to the event being documented Obligations Actor SHALL:in-narrative Producer of FHIR resources
period	S	1..1	Period	[DocumentEntry.serviceStartTime, DocumentEntry.serviceStopTime] Time of service that is being documented.
start	SO	1..1	dateTime	Starting time with inclusive boundary Obligations Actor SHALL:in-narrative Producer of FHIR resources
end	SO	0..1	dateTime	End time with inclusive boundary, if not ongoing Obligations Actor SHALL:in-narrative Producer of FHIR resources
detail	SO	0..*	Reference(Resource)	[DocumentEntry.referenceIdList] Related identifiers or resources Obligations Actor SHALL:in-narrative Producer of FHIR resources
section	S	1..*	BackboneElement	Composition is broken into sections
entry	SO	0..*	Reference(Resource)	A reference to data that supports this section Obligations Actor SHALL:in-narrative Producer of FHIR resources
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Composition.language	extensible	MedComIHE_CoreLanguageCode_TEMP http://medcomfhir.dk/ig/document/ValueSet/MedCom-ihe-core-languagecode-VS-TEMP From this IG
Composition.type	required	MedComIHE_CoreTypeCode_TEMP http://medcomfhir.dk/ig/document/ValueSet/MedCom-ihe-core-typecode-VS-TEMP From this IG
Composition.category	extensible	MedComIHE_CoreClassCode_TEMP http://medcomfhir.dk/ig/document/ValueSet/MedCom-ihe-core-classcode-VS-TEMP From this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
medcom-canonical-semver	error	Composition.meta.profile	The canonical SHALL include an explicit semantic version (semver) with optional prerelease (-...) and build metadata (+...). : matches('^.*[|][0-9]+[.][0-9]+([.][0-9]+)?(-[0-9A-Za-z-]+([.][0-9A-Za-z-]+)*)?([+][0-9A-Za-z-]+([.][0-9A-Za-z-]+)*)?$')
medcom-uuid	error	Composition.identifier.value	The value shall correspond to the structure of an UUID : $this.matches('(?i)^urn:uuid:[0-9a-f]{8}-[0-9a-f]{4}-[45][0-9a-f]{3}-[89ab][0-9a-f]{3}-[0-9a-f]{12}$')

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Composition		0..*	Composition	A set of resources composed into a single coherent clinical statement with clinical attestation
id	SOΣ	1..1	id	Logical id of this artifact Obligations Actor SHALL:in-narrative Producer of FHIR resources
meta	SΣ	1..1	Meta	Metadata about the resource
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
versionId	Σ	0..1	id	Version specific identifier
lastUpdated	Σ	0..1	instant	When the resource version last changed
source	Σ	0..1	uri	Identifies where the resource comes from
profile	SOΣC	1..1	canonical(StructureDefinition)	[DocumentEntry.formatCode] Indicates the FHIR Composition profile canonical, including an explicit version `|x.y.z`. The value does not map 1:1 to XDS DocumentEntry.formatCode and SHALL be mapped. Constraints: medcom-canonical-semver Obligations Actor SHALL:in-narrative Producer of FHIR resources
security	Σ	0..*	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag	Σ	0..*	Coding	Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language	SO	1..1	code	[DocumentEntry.languageCode] Human language of the content Binding: IHE LanguageCode_TEMP (extensible) Obligations Actor SHALL:in-narrative Producer of FHIR resources
text	S	1..1	Narrative	The narrative text SHALL always be included when exchanging a MedCom FHIR Bundle. This profile does not constrain the narrative in regard to content, language, or traceability to data elements
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
status	S	1..1	code	generated | extensions | additional | empty Binding: NarrativeStatus (required): The status of a resource narrative.
div	SC	1..1	xhtml	Limited xhtml content Constraints: txt-1, txt-2
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..1	Identifier	The Composition identifier
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	[DocumentEntry.uniqueId] Sender organization OID (Object Identifier). Example: 1.2.208.184 (MedCom OID). Example General: http://www.acme.com/identifiers/patient
value	SΣC	1..1	string	[DocumentEntry.uniqueId] UUID. Constraints: medcom-uuid Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!SOΣ	1..1	code	preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): The workflow/clinical status of the composition. Required Pattern: final Obligations Actor SHALL:in-narrative Producer of FHIR resources
type	SΣ	1..1	CodeableConcept	[DocumentEntry.typeCode] Kind of document Binding: IHE TypeCode_TEMP (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	1..1	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SOΣ	1..1	uri	Identity of the terminology system Obligations Actor SHALL:in-narrative Producer of FHIR resources
version	Σ	0..1	string	Version of the system - if relevant
code	SOΣ	1..1	code	Symbol in syntax defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
display	SOΣ	1..1	string	Representation defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
category	SΣ	0..1	CodeableConcept	[DocumentEntry.classCode] Categorization of document Binding: IHE ClassCode_TEMP (extensible)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	1..1	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SOΣ	1..1	uri	Identity of the terminology system Obligations Actor SHALL:in-narrative Producer of FHIR resources
version	Σ	0..1	string	Version of the system - if relevant
code	SOΣ	1..1	code	Symbol in syntax defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
display	SOΣ	1..1	string	Representation defined by the system Obligations Actor SHALL:in-narrative Producer of FHIR resources
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subject	SOΣ	1..1	Reference(MedComDocumentPatient) {b}	Who and/or what the composition is about Obligations Actor SHALL:in-narrative Producer of FHIR resources
encounter	Σ	0..1	Reference(Encounter)	Context of the Composition
date	SOΣ	1..1	dateTime	Composition editing time Obligations Actor SHALL:in-narrative Producer of FHIR resources
Slices for author	SOΣ	1..2	Reference(MedComDocumentOrganization | MedComDocumentPractitionerRole | MedComDocumentPractitioner | MedComDocumentPatient | Danish Core Related Person Profile | Device) {b}	[DocumentEntry.author] The slice author:institution ensures one mandatory organizational author. Any author element that does not match this slice is interpreted as an author person. Slice: Unordered, Open by profile:$this.resolve() Obligations Actor SHALL:in-narrative Producer of FHIR resources
author:institution	SOΣ	1..1	Reference(MedComDocumentOrganization)	The organization who authored the document. Obligations Actor SHALL:in-narrative Producer of FHIR resources
title	SOΣ	1..1	string	[DocumentEntry.title] The readable title of the document. Obligations Actor SHALL:in-narrative Producer of FHIR resources
confidentiality	SOΣ	1..1	code	As defined by affinity domain Binding: v3.ConfidentialityClassification (2014-03-26) (required): Codes specifying the level of confidentiality of the composition. Obligations Actor SHALL:in-narrative Producer of FHIR resources
attester	S	0..1	BackboneElement	Attests to accuracy of composition
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode	SO	1..1	code	personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition. Obligations Actor SHALL:in-narrative Producer of FHIR resources
time		0..1	dateTime	When the composition was attested
party	SO	0..1	Reference(MedComDocumentPractitioner) {b}	[DocumentEntry.legalAuthenticator] Who authenticated the document. Obligations Actor SHALL:in-narrative Producer of FHIR resources
custodian	Σ	0..1	Reference(Organization)	Organization which maintains the composition
relatesTo		0..*	BackboneElement	Relationships to other compositions/documents
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code		1..1	code	replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target[x]		1..1		Target of the relationship
targetIdentifier			Identifier
targetReference			Reference(Composition)
event	SΣ	1..1	BackboneElement	The clinical service(s) being documented
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SOΣ	0..*	CodeableConcept	Code(s) that apply to the event being documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented. Obligations Actor SHALL:in-narrative Producer of FHIR resources
period	SΣ	1..1	Period	[DocumentEntry.serviceStartTime, DocumentEntry.serviceStopTime] Time of service that is being documented.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	SOΣC	1..1	dateTime	Starting time with inclusive boundary Obligations Actor SHALL:in-narrative Producer of FHIR resources
end	SOΣC	0..1	dateTime	End time with inclusive boundary, if not ongoing Obligations Actor SHALL:in-narrative Producer of FHIR resources
detail	SOΣ	0..*	Reference(Resource)	[DocumentEntry.referenceIdList] Related identifiers or resources Obligations Actor SHALL:in-narrative Producer of FHIR resources
section	SC	1..*	BackboneElement	Composition is broken into sections Constraints: cmp-1, cmp-2
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
title		0..1	string	Label for section (e.g. for ToC)
code		0..1	CodeableConcept	Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
author		0..*	Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization)	Who and/or what authored the section
focus		0..1	Reference(Resource)	Who/what the section is about, when it is not about the subject of composition
text	C	0..1	Narrative	Text summary of the section, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
mode		0..1	code	working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy		0..1	CodeableConcept	Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry	SOC	0..*	Reference(Resource)	A reference to data that supports this section Obligations Actor SHALL:in-narrative Producer of FHIR resources
emptyReason	C	0..1	CodeableConcept	Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section	C	0..*	See section (Composition)	Nested Section
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Composition.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels|4.0.1 From the FHIR Standard
Composition.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags|4.0.1 From the FHIR Standard
Composition.language	extensible	MedComIHE_CoreLanguageCode_TEMP http://medcomfhir.dk/ig/document/ValueSet/MedCom-ihe-core-languagecode-VS-TEMP From this IG
Composition.text.status	required	NarrativeStatus http://hl7.org/fhir/ValueSet/narrative-status|4.0.1 From the FHIR Standard
Composition.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
Composition.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type|4.0.1 From the FHIR Standard
Composition.status	required	Pattern Value: final http://hl7.org/fhir/ValueSet/composition-status|4.0.1 From the FHIR Standard
Composition.type	required	MedComIHE_CoreTypeCode_TEMP http://medcomfhir.dk/ig/document/ValueSet/MedCom-ihe-core-typecode-VS-TEMP From this IG
Composition.category	extensible	MedComIHE_CoreClassCode_TEMP http://medcomfhir.dk/ig/document/ValueSet/MedCom-ihe-core-classcode-VS-TEMP From this IG
Composition.confidentiality	required	v3.ConfidentialityClassification http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26 From the FHIR Standard
Composition.attester.mode	required	CompositionAttestationMode http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1 From the FHIR Standard
Composition.relatesTo.code	required	DocumentRelationshipType http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1 From the FHIR Standard
Composition.event.code	example	ActCode http://terminology.hl7.org/ValueSet/v3-ActCode
Composition.section.code	example	DocumentSectionCodes http://hl7.org/fhir/ValueSet/doc-section-codes|4.0.1 From the FHIR Standard
Composition.section.mode	required	ListMode http://hl7.org/fhir/ValueSet/list-mode|4.0.1 From the FHIR Standard
Composition.section.orderedBy	preferred	ListOrderCodes http://hl7.org/fhir/ValueSet/list-order|4.0.1 From the FHIR Standard
Composition.section.emptyReason	preferred	ListEmptyReasons http://hl7.org/fhir/ValueSet/list-empty-reason|4.0.1 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cmp-1	error	Composition.section	A section must contain at least one of text, entries, or sub-sections : text.exists() or entry.exists() or section.exists()
cmp-2	error	Composition.section	A section can only have an emptyReason if it is empty : emptyReason.empty() or entry.empty()
dom-2	error	Composition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Composition	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	error	Composition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Composition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Composition	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
medcom-canonical-semver	error	Composition.meta.profile	The canonical SHALL include an explicit semantic version (semver) with optional prerelease (-...) and build metadata (+...). : matches('^.*[|][0-9]+[.][0-9]+([.][0-9]+)?(-[0-9A-Za-z-]+([.][0-9A-Za-z-]+)*)?([+][0-9A-Za-z-]+([.][0-9A-Za-z-]+)*)?$')
medcom-uuid	error	Composition.identifier.value	The value shall correspond to the structure of an UUID : $this.matches('(?i)^urn:uuid:[0-9a-f]{8}-[0-9a-f]{4}-[45][0-9a-f]{3}-[89ab][0-9a-f]{3}-[0-9a-f]{12}$')
txt-1	error	Composition.text.div	The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes : htmlChecks()
txt-2	error	Composition.text.div	The narrative SHALL have some non-whitespace content : htmlChecks()

This structure is derived from Composition

Summary

Mandatory: 19 elements(4 nested mandatory elements)
Must-Support: 38 elements

Structures

This structure refers to these other structures:

• MedComDocumentPatient (http://medcomfhir.dk/ig/document/StructureDefinition/medcom-document-patient)
• MedComDocumentOrganization (http://medcomfhir.dk/ig/document/StructureDefinition/medcom-document-organization)
• MedComDocumentPractitionerRole (http://medcomfhir.dk/ig/document/StructureDefinition/medcom-document-practitionerrole)
• MedComDocumentPractitioner (http://medcomfhir.dk/ig/document/StructureDefinition/medcom-document-practitioner)
• Danish Core Related Person Profile (http://hl7.dk/fhir/core/StructureDefinition/dk-core-related-person)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Composition.author