Medtech ALEX® AU Implementation Guide
1.0.0 - Trial Use

Medtech ALEX® AU Implementation Guide - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## Resource Profile: Discharge Summary

Official URL: https://alexapi.medtechglobal.com.au/fhir/StructureDefinition/alex-dischargesummary | Version: 1.0.0
Active as of 2026-01-12 | Computable Name: AlexDischargeSummary

The ALEX Discharge Summary that utilises the DocumentResource resource

Usages:

- Derived from this Profile: Discharge Summary IPS Profile
- Use this Profile: Discharge Summary Bundle
- Examples for this Profile: DocumentReference/dischargeSummary-full-example and DocumentReference/dischargeSummary-min-example

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DocumentReference | C | 0..* | DocumentReference | A reference to a document Constraints: dischargeSummary-subject-display-validation, dischargeSummary-author-display-validation, dischargeSummary-description-validation
meta | Σ | 0..1 | Meta | Metadata about the resource
lastUpdated | S Σ | 0..1 | instant | When the resource version last changed
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: Definition of Confidentiality Value Set (required)
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:comment | C | 0..1 | string | Extension URL: https://alexapi.medtechglobal.com.au/fhir/StructureDefinition/comment Constraints: comment-length
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 0..* | Identifier | Other identifiers for the document
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Required Pattern: official
value | S Σ | 0..1 | string | The value that is unique Example General: 123456
status | ?!Σ | 1..1 | code | current | superseded | entered-in-error Binding: DocumentReferenceStatus (required): The status of the document reference. Required Pattern: current
type | S Σ | 1..1 | CodeableConcept | Kind of document (LOINC if possible) Binding: DocumentTypeValueSet (preferred): Precise type of clinical document.
subject | S Σ | 1..1 | Reference(Patient | Practitioner | Group | Device) | Who/what is the subject of the document
date | S Σ | 1..1 | instant | When this document reference was created
author | S Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson) | Who and/or what authored the document
description | S Σ | 0..1 | string | Human-readable description
content | S Σ | 1..* | BackboneElement | Document referenced
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
attachment | Σ | 1..1 | Attachment | Where to access the document
contentType | S Σ | 0..1 | code | Mime type of the content, with charset etc. Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Example General: text/plain; charset=UTF-8, image/png
data | S | 0..1 | base64Binary | Data inline, base64ed
url | S Σ | 0..1 | url | Uri where the data can be found Example General: http://www.acme.com/logo-small.png
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DocumentReference.meta.​security | Base | required | Definition of Confidentiality Value Set | 📦1.0.0 | This IG
DocumentReference.identifier.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
DocumentReference.status | Base | required | DocumentReferenceStatus | 📍4.0.1 | FHIR Std.
DocumentReference.type | Base | preferred | Document Type Value Set | 📍4.0.1 | FHIR Std.
DocumentReference.relatesTo.​code | Base | required | DocumentRelationshipType | 📍4.0.1 | FHIR Std.
DocumentReference.content.​attachment.contentType | Base | required | MimeType | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
comment-length | error | DocumentReference.extension:comment | Comment size validation | `value.exists().not() or value.length() <= 200`
dischargeSummary-author-display-validation | error | DocumentReference | Author display must not exceed 35 characters | `author.display.empty() or author.display.length() <= 35`
dischargeSummary-description-validation | error | DocumentReference | Description must not exceed 50 characters | `description.empty() or description.length() <= 50`
dischargeSummary-subject-display-validation | error | DocumentReference | Subject display must not exceed 25 characters | `subject.display.empty() or subject.display.length() <= 25`
dom-2 | error | DocumentReference | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DocumentReference | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().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 | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DocumentReference | A resource should have narrative for robust management | `text.`div`.exists()`
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()`

This structure is derived from DocumentReference

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DocumentReference | C | 0..* | DocumentReference | A reference to a document Constraints: dischargeSummary-subject-display-validation, dischargeSummary-author-display-validation, dischargeSummary-description-validation
meta |  |  |  |
lastUpdated | S | 0..1 | instant | When the resource version last changed
security |  | 0..* | Coding | Security Labels applied to this resource Binding: Definition of Confidentiality Value Set (required)
implicitRules |  | 0..0 |  | A set of rules under which this content was created
language |  | 0..0 |  | Language of the resource content
contained |  | 0..0 |  | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:comment |  | 0..1 | string | Extension URL: https://alexapi.medtechglobal.com.au/fhir/StructureDefinition/comment
identifier | S | 0..* | Identifier | Other identifiers for the document
use |  | 0..1 | code | usual | official | temp | secondary | old (If known) Required Pattern: official
type |  |  |  |
coding |  |  |  |
system |  | 0..1 | uri | Identity of the terminology system Required Pattern: http://terminology.hl7.org/CodeSystem/v2-0203
code |  | 0..1 | code | Symbol in syntax defined by the system Required Pattern: FILL
value | S | 0..1 | string | The value that is unique
status |  | 1..1 | code | current | superseded | entered-in-error Required Pattern: current
docStatus |  | 0..0 |  | preliminary | final | amended | entered-in-error
type | S | 1..1 | CodeableConcept | Kind of document (LOINC if possible)
coding |  |  |  |
system |  | 0..1 | uri | Identity of the terminology system Required Pattern: http://loinc.org
code |  | 0..1 | code | Symbol in syntax defined by the system Required Pattern: 34109-9
display |  | 0..1 | string | Representation defined by the system Required Pattern: Note
category |  | 0..0 |  | Categorization of document
subject | S | 1..1 | Reference(Patient | Practitioner | Group | Device) | Who/what is the subject of the document
date | S | 1..1 | instant | When this document reference was created
author | S | 0..* | Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson) | Who and/or what authored the document
authenticator |  | 0..0 |  | Who/what authenticated the document
custodian |  | 0..0 |  | Organization which maintains the document
relatesTo |  | 0..0 |  | Relationships to other documents
description | S | 0..1 | string | Human-readable description
securityLabel |  | 0..0 |  | Document security-tags
content | S | 1..* | BackboneElement | Document referenced
attachment |  |  |  |
contentType | S | 0..1 | code | Mime type of the content, with charset etc.
data | S | 0..1 | base64Binary | Data inline, base64ed
url | S | 0..1 | url | Uri where the data can be found
context |  | 0..0 |  | Clinical context of document
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
DocumentReference.meta.​security | Base | required | Definition of Confidentiality Value Set | 📦1.0.0 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
dischargeSummary-author-display-validation | error | DocumentReference | Author display must not exceed 35 characters | `author.display.empty() or author.display.length() <= 35`
dischargeSummary-description-validation | error | DocumentReference | Description must not exceed 50 characters | `description.empty() or description.length() <= 50`
dischargeSummary-subject-display-validation | error | DocumentReference | Subject display must not exceed 25 characters | `subject.display.empty() or subject.display.length() <= 25`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DocumentReference | C | 0..* | DocumentReference | A reference to a document Constraints: dischargeSummary-subject-display-validation, dischargeSummary-author-display-validation, dischargeSummary-description-validation
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..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 | S Σ | 0..1 | instant | When the resource version last changed
source | Σ | 0..1 | uri | Identifies where the resource comes from
profile | Σ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: Definition of Confidentiality Value Set (required)
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".
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:comment | C | 0..1 | string | Extension URL: https://alexapi.medtechglobal.com.au/fhir/StructureDefinition/comment Constraints: comment-length
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
masterIdentifier | Σ | 0..1 | Identifier | Master Version Specific Identifier
identifier | S Σ | 0..* | Identifier | Other identifiers for the document
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 . Required Pattern: official
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.
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 | Σ | 0..* | 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 | Σ | 0..1 | uri | Identity of the terminology system Required Pattern: http://terminology.hl7.org/CodeSystem/v2-0203
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 0..1 | code | Symbol in syntax defined by the system Required Pattern: FILL
display | Σ | 0..1 | string | Representation defined by the system
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
system | Σ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 0..1 | string | The value that is unique 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 | ?!Σ | 1..1 | code | current | superseded | entered-in-error Binding: DocumentReferenceStatus (required): The status of the document reference. Required Pattern: current
type | S Σ | 1..1 | CodeableConcept | Kind of document (LOINC if possible) Binding: DocumentTypeValueSet (preferred): Precise type of clinical document.
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 | Σ | 0..* | 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 | Σ | 0..1 | uri | Identity of the terminology system Required Pattern: http://loinc.org
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 0..1 | code | Symbol in syntax defined by the system Required Pattern: 34109-9
display | Σ | 0..1 | string | Representation defined by the system Required Pattern: Note
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 | S Σ | 1..1 | Reference(Patient | Practitioner | Group | Device) | Who/what is the subject of the document
date | S Σ | 1..1 | instant | When this document reference was created
author | S Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson) | Who and/or what authored the document
description | S Σ | 0..1 | string | Human-readable description
content | S Σ | 1..* | BackboneElement | Document referenced
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
attachment | Σ | 1..1 | Attachment | Where to access the document
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
contentType | S Σ | 0..1 | code | Mime type of the content, with charset etc. Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Example General: text/plain; charset=UTF-8, image/png
language | Σ | 0..1 | code | Human language of the content (BCP-47) Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Example General: en-AU
data | S | 0..1 | base64Binary | Data inline, base64ed
url | S Σ | 0..1 | url | Uri where the data can be found Example General: http://www.acme.com/logo-small.png
size | Σ | 0..1 | unsignedInt | Number of bytes of content (if url provided)
hash | Σ | 0..1 | base64Binary | Hash of the data (sha-1, base64ed)
title | Σ | 0..1 | string | Label to display in place of the data Example General: Official Corporate Logo
creation | Σ | 0..1 | dateTime | Date attachment was first created
format | Σ | 0..1 | Coding | Format/content rules for the document Binding: DocumentReferenceFormatCodeSet (preferred): Document Format Codes.
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DocumentReference.meta.​security | Base | required | Definition of Confidentiality Value Set | 📦1.0.0 | This IG
DocumentReference.meta.​tag | Base | example | Common Tags | 📍4.0.1 | FHIR Std.
DocumentReference.identifier.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
DocumentReference.identifier.​type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std.
DocumentReference.status | Base | required | DocumentReferenceStatus | 📍4.0.1 | FHIR Std.
DocumentReference.type | Base | preferred | Document Type Value Set | 📍4.0.1 | FHIR Std.
DocumentReference.relatesTo.​code | Base | required | DocumentRelationshipType | 📍4.0.1 | FHIR Std.
DocumentReference.content.​attachment.contentType | Base | required | MimeType | 📍4.0.1 | FHIR Std.
DocumentReference.content.​attachment.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
DocumentReference.content.​format | Base | preferred | DocumentReference Format Code Set | 📍4.0.1 | FHIR Std.
DocumentReference.context.​event | Base | example | v3 Code System ActCode | 📦3.0.0 | THO v5.5
DocumentReference.context.​facilityType | Base | example | Facility Type Code Value Set | 📍4.0.1 | FHIR Std.
DocumentReference.context.​practiceSetting | Base | example | Practice Setting Code Value Set | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
comment-length | error | DocumentReference.extension:comment | Comment size validation | `value.exists().not() or value.length() <= 200`
dischargeSummary-author-display-validation | error | DocumentReference | Author display must not exceed 35 characters | `author.display.empty() or author.display.length() <= 35`
dischargeSummary-description-validation | error | DocumentReference | Description must not exceed 50 characters | `description.empty() or description.length() <= 50`
dischargeSummary-subject-display-validation | error | DocumentReference | Subject display must not exceed 25 characters | `subject.display.empty() or subject.display.length() <= 25`
dom-2 | error | DocumentReference | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DocumentReference | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().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 | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DocumentReference | A resource should have narrative for robust management | `text.`div`.exists()`
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()`

This structure is derived from DocumentReference

Summary

Mandatory: 3 elements
Must-Support: 12 elements
Prohibited: 10 elements

Extensions

This structure refers to these extensions:

- https://alexapi.medtechglobal.com.au/fhir/StructureDefinition/comment

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DocumentReference | C | 0..* | DocumentReference | A reference to a document Constraints: dischargeSummary-subject-display-validation, dischargeSummary-author-display-validation, dischargeSummary-description-validation
meta | Σ | 0..1 | Meta | Metadata about the resource
lastUpdated | S Σ | 0..1 | instant | When the resource version last changed
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: Definition of Confidentiality Value Set (required)
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:comment | C | 0..1 | string | Extension URL: https://alexapi.medtechglobal.com.au/fhir/StructureDefinition/comment Constraints: comment-length
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 0..* | Identifier | Other identifiers for the document
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Required Pattern: official
value | S Σ | 0..1 | string | The value that is unique Example General: 123456
status | ?!Σ | 1..1 | code | current | superseded | entered-in-error Binding: DocumentReferenceStatus (required): The status of the document reference. Required Pattern: current
type | S Σ | 1..1 | CodeableConcept | Kind of document (LOINC if possible) Binding: DocumentTypeValueSet (preferred): Precise type of clinical document.
subject | S Σ | 1..1 | Reference(Patient | Practitioner | Group | Device) | Who/what is the subject of the document
date | S Σ | 1..1 | instant | When this document reference was created
author | S Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson) | Who and/or what authored the document
description | S Σ | 0..1 | string | Human-readable description
content | S Σ | 1..* | BackboneElement | Document referenced
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
attachment | Σ | 1..1 | Attachment | Where to access the document
contentType | S Σ | 0..1 | code | Mime type of the content, with charset etc. Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Example General: text/plain; charset=UTF-8, image/png
data | S | 0..1 | base64Binary | Data inline, base64ed
url | S Σ | 0..1 | url | Uri where the data can be found Example General: http://www.acme.com/logo-small.png
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DocumentReference.meta.​security | Base | required | Definition of Confidentiality Value Set | 📦1.0.0 | This IG
DocumentReference.identifier.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
DocumentReference.status | Base | required | DocumentReferenceStatus | 📍4.0.1 | FHIR Std.
DocumentReference.type | Base | preferred | Document Type Value Set | 📍4.0.1 | FHIR Std.
DocumentReference.relatesTo.​code | Base | required | DocumentRelationshipType | 📍4.0.1 | FHIR Std.
DocumentReference.content.​attachment.contentType | Base | required | MimeType | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
comment-length | error | DocumentReference.extension:comment | Comment size validation | `value.exists().not() or value.length() <= 200`
dischargeSummary-author-display-validation | error | DocumentReference | Author display must not exceed 35 characters | `author.display.empty() or author.display.length() <= 35`
dischargeSummary-description-validation | error | DocumentReference | Description must not exceed 50 characters | `description.empty() or description.length() <= 50`
dischargeSummary-subject-display-validation | error | DocumentReference | Subject display must not exceed 25 characters | `subject.display.empty() or subject.display.length() <= 25`
dom-2 | error | DocumentReference | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DocumentReference | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().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 | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DocumentReference | A resource should have narrative for robust management | `text.`div`.exists()`
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()`

Differential View

This structure is derived from DocumentReference

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DocumentReference | C | 0..* | DocumentReference | A reference to a document Constraints: dischargeSummary-subject-display-validation, dischargeSummary-author-display-validation, dischargeSummary-description-validation
meta |  |  |  |
lastUpdated | S | 0..1 | instant | When the resource version last changed
security |  | 0..* | Coding | Security Labels applied to this resource Binding: Definition of Confidentiality Value Set (required)
implicitRules |  | 0..0 |  | A set of rules under which this content was created
language |  | 0..0 |  | Language of the resource content
contained |  | 0..0 |  | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:comment |  | 0..1 | string | Extension URL: https://alexapi.medtechglobal.com.au/fhir/StructureDefinition/comment
identifier | S | 0..* | Identifier | Other identifiers for the document
use |  | 0..1 | code | usual | official | temp | secondary | old (If known) Required Pattern: official
type |  |  |  |
coding |  |  |  |
system |  | 0..1 | uri | Identity of the terminology system Required Pattern: http://terminology.hl7.org/CodeSystem/v2-0203
code |  | 0..1 | code | Symbol in syntax defined by the system Required Pattern: FILL
value | S | 0..1 | string | The value that is unique
status |  | 1..1 | code | current | superseded | entered-in-error Required Pattern: current
docStatus |  | 0..0 |  | preliminary | final | amended | entered-in-error
type | S | 1..1 | CodeableConcept | Kind of document (LOINC if possible)
coding |  |  |  |
system |  | 0..1 | uri | Identity of the terminology system Required Pattern: http://loinc.org
code |  | 0..1 | code | Symbol in syntax defined by the system Required Pattern: 34109-9
display |  | 0..1 | string | Representation defined by the system Required Pattern: Note
category |  | 0..0 |  | Categorization of document
subject | S | 1..1 | Reference(Patient | Practitioner | Group | Device) | Who/what is the subject of the document
date | S | 1..1 | instant | When this document reference was created
author | S | 0..* | Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson) | Who and/or what authored the document
authenticator |  | 0..0 |  | Who/what authenticated the document
custodian |  | 0..0 |  | Organization which maintains the document
relatesTo |  | 0..0 |  | Relationships to other documents
description | S | 0..1 | string | Human-readable description
securityLabel |  | 0..0 |  | Document security-tags
content | S | 1..* | BackboneElement | Document referenced
attachment |  |  |  |
contentType | S | 0..1 | code | Mime type of the content, with charset etc.
data | S | 0..1 | base64Binary | Data inline, base64ed
url | S | 0..1 | url | Uri where the data can be found
context |  | 0..0 |  | Clinical context of document
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
DocumentReference.meta.​security | Base | required | Definition of Confidentiality Value Set | 📦1.0.0 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
dischargeSummary-author-display-validation | error | DocumentReference | Author display must not exceed 35 characters | `author.display.empty() or author.display.length() <= 35`
dischargeSummary-description-validation | error | DocumentReference | Description must not exceed 50 characters | `description.empty() or description.length() <= 50`
dischargeSummary-subject-display-validation | error | DocumentReference | Subject display must not exceed 25 characters | `subject.display.empty() or subject.display.length() <= 25`

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DocumentReference | C | 0..* | DocumentReference | A reference to a document Constraints: dischargeSummary-subject-display-validation, dischargeSummary-author-display-validation, dischargeSummary-description-validation
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..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 | S Σ | 0..1 | instant | When the resource version last changed
source | Σ | 0..1 | uri | Identifies where the resource comes from
profile | Σ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to
security | Σ | 0..* | Coding | Security Labels applied to this resource Binding: Definition of Confidentiality Value Set (required)
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".
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:comment | C | 0..1 | string | Extension URL: https://alexapi.medtechglobal.com.au/fhir/StructureDefinition/comment Constraints: comment-length
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
masterIdentifier | Σ | 0..1 | Identifier | Master Version Specific Identifier
identifier | S Σ | 0..* | Identifier | Other identifiers for the document
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 . Required Pattern: official
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.
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 | Σ | 0..* | 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 | Σ | 0..1 | uri | Identity of the terminology system Required Pattern: http://terminology.hl7.org/CodeSystem/v2-0203
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 0..1 | code | Symbol in syntax defined by the system Required Pattern: FILL
display | Σ | 0..1 | string | Representation defined by the system
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
system | Σ | 0..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 0..1 | string | The value that is unique 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 | ?!Σ | 1..1 | code | current | superseded | entered-in-error Binding: DocumentReferenceStatus (required): The status of the document reference. Required Pattern: current
type | S Σ | 1..1 | CodeableConcept | Kind of document (LOINC if possible) Binding: DocumentTypeValueSet (preferred): Precise type of clinical document.
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 | Σ | 0..* | 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 | Σ | 0..1 | uri | Identity of the terminology system Required Pattern: http://loinc.org
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 0..1 | code | Symbol in syntax defined by the system Required Pattern: 34109-9
display | Σ | 0..1 | string | Representation defined by the system Required Pattern: Note
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 | S Σ | 1..1 | Reference(Patient | Practitioner | Group | Device) | Who/what is the subject of the document
date | S Σ | 1..1 | instant | When this document reference was created
author | S Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson) | Who and/or what authored the document
description | S Σ | 0..1 | string | Human-readable description
content | S Σ | 1..* | BackboneElement | Document referenced
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
attachment | Σ | 1..1 | Attachment | Where to access the document
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
contentType | S Σ | 0..1 | code | Mime type of the content, with charset etc. Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Example General: text/plain; charset=UTF-8, image/png
language | Σ | 0..1 | code | Human language of the content (BCP-47) Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Example General: en-AU
data | S | 0..1 | base64Binary | Data inline, base64ed
url | S Σ | 0..1 | url | Uri where the data can be found Example General: http://www.acme.com/logo-small.png
size | Σ | 0..1 | unsignedInt | Number of bytes of content (if url provided)
hash | Σ | 0..1 | base64Binary | Hash of the data (sha-1, base64ed)
title | Σ | 0..1 | string | Label to display in place of the data Example General: Official Corporate Logo
creation | Σ | 0..1 | dateTime | Date attachment was first created
format | Σ | 0..1 | Coding | Format/content rules for the document Binding: DocumentReferenceFormatCodeSet (preferred): Document Format Codes.
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DocumentReference.meta.​security | Base | required | Definition of Confidentiality Value Set | 📦1.0.0 | This IG
DocumentReference.meta.​tag | Base | example | Common Tags | 📍4.0.1 | FHIR Std.
DocumentReference.identifier.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
DocumentReference.identifier.​type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std.
DocumentReference.status | Base | required | DocumentReferenceStatus | 📍4.0.1 | FHIR Std.
DocumentReference.type | Base | preferred | Document Type Value Set | 📍4.0.1 | FHIR Std.
DocumentReference.relatesTo.​code | Base | required | DocumentRelationshipType | 📍4.0.1 | FHIR Std.
DocumentReference.content.​attachment.contentType | Base | required | MimeType | 📍4.0.1 | FHIR Std.
DocumentReference.content.​attachment.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
DocumentReference.content.​format | Base | preferred | DocumentReference Format Code Set | 📍4.0.1 | FHIR Std.
DocumentReference.context.​event | Base | example | v3 Code System ActCode | 📦3.0.0 | THO v5.5
DocumentReference.context.​facilityType | Base | example | Facility Type Code Value Set | 📍4.0.1 | FHIR Std.
DocumentReference.context.​practiceSetting | Base | example | Practice Setting Code Value Set | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
comment-length | error | DocumentReference.extension:comment | Comment size validation | `value.exists().not() or value.length() <= 200`
dischargeSummary-author-display-validation | error | DocumentReference | Author display must not exceed 35 characters | `author.display.empty() or author.display.length() <= 35`
dischargeSummary-description-validation | error | DocumentReference | Description must not exceed 50 characters | `description.empty() or description.length() <= 50`
dischargeSummary-subject-display-validation | error | DocumentReference | Subject display must not exceed 25 characters | `subject.display.empty() or subject.display.length() <= 25`
dom-2 | error | DocumentReference | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DocumentReference | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().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 | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DocumentReference | A resource should have narrative for robust management | `text.`div`.exists()`
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()`

This structure is derived from DocumentReference

Summary

Mandatory: 3 elements
Must-Support: 12 elements
Prohibited: 10 elements

Extensions

This structure refers to these extensions:

- https://alexapi.medtechglobal.com.au/fhir/StructureDefinition/comment

Other representations of profile: CSV, Excel, Schematron