# entry[].resource.description
Grouping subject participation within a research study is helpful to provide definitive lists of participants that fit a specific criteria such as *All Participants* or *Participants From a Particular Consent Group*, etc. 

# entry[].resource.snapshot.element[].comment
If both Group.characteristic and Group.member are present, then the members are the individuals who were found who met the characteristic.  It's possible that there might be other candidate members who meet the characteristic and aren't (yet) in the list.  All members SHALL have the listed characteristics.

# entry[].resource.snapshot.element[].constraint[].human
If the resource is contained in another resource, it SHALL NOT contain nested Resources

# entry[].resource.snapshot.element[].constraint[].human
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

# entry[].resource.snapshot.element[].constraint[].human
If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated

# entry[].resource.snapshot.element[].constraint[].human
If a resource is contained in another resource, it SHALL NOT have a security label

# entry[].resource.snapshot.element[].constraint[].extension[].valueMarkdown
When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.

# entry[].resource.snapshot.element[].constraint[].human
A resource should have narrative for robust management

# entry[].resource.snapshot.element[].constraint[].human
Can only have members if group is "actual"

# entry[].resource.snapshot.element[].definition
Represents a defined collection of entities that may be discussed or acted upon collectively but which are not expected to act collectively, and are not formally or legally recognized; i.e. a collection of entities that isn't an Organization.

# entry[].resource.snapshot.element[].comment
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

# entry[].resource.snapshot.element[].definition
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

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

# entry[].resource.snapshot.element[].isModifierReason
This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation

# entry[].resource.snapshot.element[].short
A set of rules under which this content was created

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The base language in which the resource is written.

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

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

# entry[].resource.snapshot.element[].short
Text summary of the resource, for human interpretation

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

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A unique business identifier for this group.

# entry[].resource.snapshot.element[].requirements
Allows the group to be referenced from external specifications.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Indicates whether the record for the group is available for use or is merely being retained for historical purposes.

# entry[].resource.snapshot.element[].meaningWhenMissing
This resource is generally assumed to be active if no value is provided for the active element

# entry[].resource.snapshot.element[].requirements
Need to be able to mark a group record as not to be used because it was created in error or is otherwise no longer available (e.g. a herd that no longer exists).

# entry[].resource.snapshot.element[].short
Whether this group's record is in active use

# entry[].resource.snapshot.element[].binding.description
Types of resources that are part of group.

# entry[].resource.snapshot.element[].comment
Group members SHALL be of the appropriate resource type (Patient for person or animal; or Practitioner, Device, Medication or Substance for the other types.).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Identifies the broad classification of the kind of resources the group includes.

# entry[].resource.snapshot.element[].mapping[].map
person: ./classCode="PSN"  animal: ./classCode="ANM"  device: ./classCode="DEV"  medication: ./classCode="MMAT" and ./playedRole[isNormalRole() and classCode="THER"]  food: ./classCode="FOOD"

# entry[].resource.snapshot.element[].requirements
Identifies what type of resources the group is made up of.

# entry[].resource.snapshot.element[].short
person | animal | practitioner | device | medication | substance

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
If true, indicates that the resource refers to a specific group of real individuals.  If false, the group defines a set of intended individuals.

# entry[].resource.snapshot.element[].requirements
There are use-cases for groups that define specific collections of individuals, and other groups that define "types" of intended individuals.  The requirements for both kinds of groups are similar, so we use a single resource, distinguished by this flag.

# entry[].resource.snapshot.element[].binding.description
Kind of particular resource; e.g. cow, syringe, lake, etc.

# entry[].resource.snapshot.element[].comment
This would generally be omitted for Person resources.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Provides a specific type of resource the group includes; e.g. "cow", "syringe", etc.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A label assigned to the group for human identification and communication.

# entry[].resource.snapshot.element[].requirements
Used to identify the group in human communication.

# entry[].resource.snapshot.element[].comment
Note that the quantity may be less than the number of members if some of the members are not active.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A count of the number of resource instances that are part of the group.

# entry[].resource.snapshot.element[].requirements
Group size is a common defining characteristic.

# entry[].resource.snapshot.element[].comment
This does not strictly align with ownership of a herd or flock, but may suffice to represent that relationship in simple cases. More complex cases will require an extension.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Entity responsible for defining and maintaining Group characteristics and/or registered members.

# entry[].resource.snapshot.element[].short
Entity that is the custodian of the Group's definition

# entry[].resource.snapshot.element[].comment
All the identified characteristics must be true for an entity to a member of the group.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Identifies traits whose presence r absence is shared by members of the group.

# entry[].resource.snapshot.element[].requirements
Needs to be a generic mechanism for identifying what individuals can be part of a group.

# entry[].resource.snapshot.element[].short
Include / Exclude group members by Trait

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].binding.description
List of characteristics used to describe group members; e.g. gender, age, owner, location, etc.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A code that identifies the kind of trait being asserted.

# entry[].resource.snapshot.element[].requirements
Need a formal way of identifying the characteristic being described.

# entry[].resource.snapshot.element[].binding.description
Value of descriptive member characteristic; e.g. red, male, pneumonia, Caucasian, etc.

# entry[].resource.snapshot.element[].comment
For Range, it means members of the group have a value that falls somewhere within the specified range.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The value of the trait that holds (or does not hold - see 'exclude') for members of the group.

# entry[].resource.snapshot.element[].requirements
The value of the characteristic is what determines group membership.

# entry[].resource.snapshot.element[].comment
This is labeled as "Is Modifier" because applications cannot wrongly include excluded members as included or vice versa.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
If true, indicates the characteristic is one that is NOT held by members of the group.

# entry[].resource.snapshot.element[].requirements
Sometimes group membership is determined by characteristics not possessed.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The period over which the characteristic is tested; e.g. the patient had an operation during the month of June.

# entry[].resource.snapshot.element[].short
Period over which characteristic is tested

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Identifies the resource instances that are members of the group.

# entry[].resource.snapshot.element[].requirements
Often the only thing of interest about a group is "who's in it".

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A reference to the entity that is a member of the group. Must be consistent with Group.type. If the entity is another group, then the type must be the same.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The period that the member was in the group, if known.

# entry[].resource.snapshot.element[].requirements
Need to track who was in a group at a  particular time.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A flag to indicate that the member is no longer in the group, but previously may have been a member.

# entry[].resource.snapshot.element[].meaningWhenMissing
Members are considered active unless explicitly specified otherwise

# entry[].resource.snapshot.element[].requirements
Sometimes you don't know when someone stopped being in a group, but not when.

# entry[].resource.text.div
Name | Flags | Card. | Type | Description & Constraints
Group | | 0..* | Group | Group of multiple entities

type

1..1

code

person | animal | practitioner | device | medication | substance
Required Pattern: person

actual

1..1

boolean

Descriptive or actual
Required Pattern: true

code

0..1

CodeableConcept

Kind of Group members
Required Pattern: At least the following

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

system

1..1

uri

Identity of the terminology system
Fixed Value: http://purl.obolibrary.org/obo/ncit.owl

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: C142710

display

1..1

string

Representation defined by the system
Fixed Value: Study Participant

quantity | | 1..1 | unsignedInt | Number of members
member | | | |
entity | | 1..1 | Reference(Patient) | Reference to the group member

Documentation for this format

# entry[].resource.description
Based on the FHIR resource type, ConceptMap, the StudyDataDictionaryHarmony resource provides insight into the transformations made during the ETL from source data into FHIR allowing clients to use the $translate function to discover all of the public codes that were mapped from one of the study's actual vocabulary.

# entry[].resource.snapshot.element[].definition
A statement of relationships from one set of concepts to one or more other concepts - either concepts in code systems, or data element/data element concepts, or classes in class models.

# entry[].resource.snapshot.element[].short
A map from one set of concepts to one or more other concepts

# entry[].resource.snapshot.element[].comment
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

# entry[].resource.snapshot.element[].definition
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

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

# entry[].resource.snapshot.element[].isModifierReason
This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation

# entry[].resource.snapshot.element[].short
A set of rules under which this content was created

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The base language in which the resource is written.

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

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

# entry[].resource.snapshot.element[].short
Text summary of the resource, for human interpretation

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

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].comment
Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred.  Multiple instances may share the same URL if they have a distinct version.

The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author.  Considerations for making this decision are found in [Technical and Business Versions](http://hl7.org/fhir/R4/resource.html#versions). 

In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the [meta.source](http://hl7.org/fhir/R4/resource.html#meta) element to indicate where the current master source of the resource can be found.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
An absolute URI that is used to identify this concept map when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative instance of this concept map is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the concept map is stored on different servers.

# entry[].resource.snapshot.element[].requirements
Allows the concept map to be referenced by a single globally unique identifier.

# entry[].resource.snapshot.element[].short
Canonical identifier for this concept map, represented as a URI (globally unique)

# entry[].resource.snapshot.element[].comment
Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this concept map outside of FHIR, where it is not possible to use the logical URI.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A formal identifier that is used to identify this concept map when it is represented in other formats, or referenced in a specification, model, design or an instance.

# entry[].resource.snapshot.element[].requirements
Allows externally provided and/or usable business identifiers to be easily associated with the module.

# entry[].resource.snapshot.element[].short
Additional identifier for the concept map

# entry[].resource.snapshot.element[].comment
There may be different concept map instances that have the same identifier but different versions.  The version can be appended to the url in a reference to allow a reference to a particular business version of the concept map with the format [url]|[version].

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The identifier that is used to identify this version of the concept map when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the concept map author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence.

# entry[].resource.snapshot.element[].comment
The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A natural language name identifying the concept map. This name should be usable as an identifier for the module by machine processing applications such as code generation.

# entry[].resource.snapshot.element[].requirements
Support human navigation and code generation.

# entry[].resource.snapshot.element[].short
Name for this concept map (computer friendly)

# entry[].resource.snapshot.element[].comment
This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A short, descriptive, user-friendly title for the concept map.

# entry[].resource.snapshot.element[].short
Name for this concept map (human friendly)

# entry[].resource.snapshot.element[].comment
Allows filtering of concept maps that are appropriate for use versus not.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The status of this concept map. Enables tracking the life-cycle of the content.

# entry[].resource.snapshot.element[].isModifierReason
This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration

# entry[].resource.snapshot.element[].comment
Allows filtering of concept maps that are appropriate for use versus not.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A Boolean value to indicate that this concept map is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage.

# entry[].resource.snapshot.element[].requirements
Enables experimental content to be developed following the same lifecycle that would be used for a production-level concept map.

# entry[].resource.snapshot.element[].comment
Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the concept map. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The date  (and optionally time) when the concept map was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the concept map changes.

# entry[].resource.snapshot.element[].comment
Usually an organization but may be an individual. The publisher (or steward) of the concept map is the organization or individual primarily responsible for the maintenance and upkeep of the concept map. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the concept map. This item SHOULD be populated unless the information is available from context.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The name of the organization or individual that published the concept map.

# entry[].resource.snapshot.element[].requirements
Helps establish the "authority/credibility" of the concept map.  May also allow for contact.

# entry[].resource.snapshot.element[].short
Name of the publisher (organization or individual)

# entry[].resource.snapshot.element[].comment
May be a web site, an email address, a telephone number, etc.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Contact details to assist a user in finding and communicating with the publisher.

# entry[].resource.snapshot.element[].comment
The description is not intended to describe the semantics of the concept map. The description should capture its intended use, which is needed for ensuring integrity for its use in models across future changes.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A free text natural language description of the concept map from a consumer's perspective.

# entry[].resource.snapshot.element[].short
Natural language description of the concept map

# entry[].resource.snapshot.element[].comment
When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate concept map instances.

# entry[].resource.snapshot.element[].requirements
Assist in searching for appropriate content.

# entry[].resource.snapshot.element[].short
The context that the content is intended to support

# entry[].resource.snapshot.element[].binding.description
Countries and regions within which this artifact is targeted for use.

# entry[].resource.snapshot.element[].comment
It may be possible for the concept map to be used in jurisdictions other than those for which it was originally designed or intended.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A legal or geographic region in which the concept map is intended to be used.

# entry[].resource.snapshot.element[].short
Intended jurisdiction for concept map (if applicable)

# entry[].resource.snapshot.element[].comment
This element does not describe the usage of the concept map. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is.  This may be used to point to source materials or specifications that drove the structure of this concept map.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Explanation of why this concept map is needed and why it has been designed as it has.

# entry[].resource.snapshot.element[].comment
Frequently the copyright differs between the concept map and codes that are included. The copyright statement should clearly differentiate between these when required.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A copyright statement relating to the concept map and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the concept map.

# entry[].resource.snapshot.element[].requirements
Consumers must be able to determine any legal restrictions on the use of the concept map and/or its content.

# entry[].resource.snapshot.element[].comment
Should be a version specific reference. URIs SHOULD be absolute. If there is no source or target value set, there is no specified context for the map (not recommended).  The source value set may select codes from either an explicit (standard or local) or implicit code system.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Identifier for the source value set that contains the concepts that are being mapped and provides context for the mappings.

# entry[].resource.snapshot.element[].short
The source value set that contains the concepts that are being mapped

# entry[].resource.snapshot.element[].comment
Should be a version specific reference. URIs SHOULD be absolute. If there is no source or target value set, the is no specified context for the map.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The target value set provides context for the mappings. Note that the mapping is made between concepts, not between value sets, but the value set provides important context about how the concept mapping choices are made.

# entry[].resource.snapshot.element[].short
The target value set which provides context for the mappings

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A group of mappings that all have the same source and target system.

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].comment
This is not needed if the source value set is specified and it contains concepts from only a single system.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
An absolute URI that identifies the source system where the concepts to be mapped are defined.

# entry[].resource.snapshot.element[].short
Source system where concepts to be mapped are defined

# entry[].resource.snapshot.element[].comment
The specification of a particular code system version may be required for code systems which lack concept permanence.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The specific version of the code system, as determined by the code system authority.

# entry[].resource.snapshot.element[].comment
This is not needed if the target value set is specified and it contains concepts from only a single system. The group target may also be omitted if all of the target element equivalence values are 'unmatched'.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
An absolute URI that identifies the target system that the concepts will be mapped to.

# entry[].resource.snapshot.element[].short
Target system that the concepts are to be mapped to

# entry[].resource.snapshot.element[].comment
The specification of a particular code system version may be required for code systems which lack concept permanence.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The specific version of the code system, as determined by the code system authority.

# entry[].resource.snapshot.element[].comment
Generally, the ideal is that there would only be one mapping for each concept in the source value set, but a given concept may be mapped multiple times with different comments or dependencies.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Mappings for an individual concept in the source to one or more concepts in the target.

# entry[].resource.snapshot.element[].short
Mappings for a concept from the source set

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Identity (code or path) or the element/item being mapped.

# entry[].resource.snapshot.element[].comment
The display is ignored when processing the map.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The display for the code. The display is only provided to help editors when editing the concept map.

# entry[].resource.snapshot.element[].comment
Ideally there would only be one map, with equal or equivalent mapping. But multiple maps are allowed for several narrower options, or to assert that other concepts are unmatched.

# entry[].resource.snapshot.element[].constraint[].expression
comment.exists() or equivalence.empty() or ((equivalence != 'narrower') and (equivalence != 'inexact'))

# entry[].resource.snapshot.element[].constraint[].human
If the map is narrower or inexact, there SHALL be some comments

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A concept from the target value set that this concept maps to.

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Identity (code or path) or the element/item that the map refers to.

# entry[].resource.snapshot.element[].comment
The display is ignored when processing the map.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The display for the code. The display is only provided to help editors when editing the concept map.

# entry[].resource.snapshot.element[].binding.description
The degree of equivalence between concepts.

# entry[].resource.snapshot.element[].comment
This element is labeled as a modifier because it may indicate that a target does not apply.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The equivalence between the source and target concepts (counting for the dependencies and products). The equivalence is read from target to source (e.g. the target is 'wider' than the source).

# entry[].resource.snapshot.element[].isModifierReason
Some of the values mean that there is no mapping from the source to the target, particularly 'disjoint', and the mapping cannot be interpreted without knowing this value as it could mean the elements are equivalent, totally mismatched or anything in between

# entry[].resource.snapshot.element[].short
relatedto | equivalent | equal | wider | subsumes | narrower | specializes | inexact | unmatched | disjoint

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A description of status/issues in mapping that conveys additional information not represented in  the structured data.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A set of additional dependencies for this mapping to hold. This mapping is only applicable if the specified element can be resolved, and it has the specified value.

# entry[].resource.snapshot.element[].short
Other elements required for this mapping (from context)

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A reference to an element that holds a coded value that corresponds to a code system property. The idea is that the information model carries an element somewhere that is labeled to correspond with a code system property.

# entry[].resource.snapshot.element[].short
Reference to property mapping depends on

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
An absolute URI that identifies the code system of the dependency code (if the source/dependency is a value set that crosses code systems).

# entry[].resource.snapshot.element[].meaningWhenMissing
The code is in the source (dependsOn) or target (product) system

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Identity (code or path) or the element/item/ValueSet/text that the map depends on / refers to.

# entry[].resource.snapshot.element[].comment
The display is ignored when processing the map.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The display for the code. The display is only provided to help editors when editing the concept map.

# entry[].resource.snapshot.element[].short
Display for the code (if value is a code)

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A set of additional outcomes from this mapping to other elements. To properly execute this mapping, the specified element must be mapped to some data element or source that is in context. The mapping may still be useful without a place for the additional data elements, but the equivalence cannot be relied on.

# entry[].resource.snapshot.element[].short
Other concepts that this mapping also produces

# entry[].resource.snapshot.element[].comment
This only applies if the source code has a system value that matches the system defined for the group.

# entry[].resource.snapshot.element[].constraint[].human
If the mode is 'fixed', a code must be provided

# entry[].resource.snapshot.element[].constraint[].xpath
(f:mode/@value != 'fixed') or exists(f:code)

# entry[].resource.snapshot.element[].constraint[].expression
(mode = 'other-map') implies url.exists()

# entry[].resource.snapshot.element[].constraint[].human
If the mode is 'other-map', a url must be provided

# entry[].resource.snapshot.element[].constraint[].xpath
(f:mode/@value != 'other-map') or exists(f:url)

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
What to do when there is no mapping for the source concept. "Unmapped" does not include codes that are unmatched, and the unmapped element is ignored in a code is specified to have equivalence = unmatched.

# entry[].resource.snapshot.element[].short
What to do when there is no mapping for the source concept

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].binding.description
Defines which action to take if there is no match in the group.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Defines which action to take if there is no match for the source concept in the target system designated for the group. One of 3 actions are possible: use the unmapped code (this is useful when doing a mapping between versions, and only a few codes have changed), use a fixed code (a default code), or alternatively, a reference to a different concept map can be provided (by canonical URL).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The fixed code to use when the mode = 'fixed'  - all unmapped codes are mapped to a single fixed code.

# entry[].resource.snapshot.element[].comment
The display is ignored when processing the map.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The display for the code. The display is only provided to help editors when editing the concept map.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The canonical reference to an additional ConceptMap resource instance to use for mapping if this ConceptMap resource contains no matching mapping for the source concept.

# entry[].resource.snapshot.element[].short
canonical reference to an additional ConceptMap to use for mapping if the source concept is unmapped

# entry[].resource.text.div
Name | Flags | Card. | Type | Description & Constraints
ConceptMap | | 0..* | ConceptMap | A map from one set of concepts to one or more other concepts

Documentation for this format

# entry[].resource.description
Representation of phenotypic observations (present or absent)

# entry[].resource.snapshot.element[].definition
A clinical condition, problem, diagnosis, or other event, situation, issue, or clinical concept that has risen to a level of concern.

# entry[].resource.snapshot.element[].mapping[].map
< 243796009 |Situation with explicit context| : 246090004 |Associated finding| = ( ( < 404684003 |Clinical finding| MINUS ( << 420134006 |Propensity to adverse reactions| OR << 473010000 |Hypersensitivity condition| OR << 79899007 |Drug interaction| OR << 69449002 |Drug action| OR << 441742003 |Evaluation finding| OR << 307824009 |Administrative status| OR << 385356007 |Tumor stage finding|)) OR < 272379006 |Event|)

# entry[].resource.snapshot.element[].short
Detailed information about conditions, problems or diagnoses

# entry[].resource.snapshot.element[].comment
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

# entry[].resource.snapshot.element[].definition
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

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

# entry[].resource.snapshot.element[].isModifierReason
This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation

# entry[].resource.snapshot.element[].short
A set of rules under which this content was created

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The base language in which the resource is written.

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

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

# entry[].resource.snapshot.element[].short
Text summary of the resource, for human interpretation

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

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].comment
This is a business identifier, not a resource identifier (see [discussion](http://hl7.org/fhir/R4/resource.html#identifiers)).  It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types.  For example, multiple Patient and a Person resource instance might share the same social insurance number.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Business identifiers assigned to this condition by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

# entry[].resource.snapshot.element[].requirements
Allows identification of the condition as it is known by various participating systems and in a way that remains consistent across servers.

# entry[].resource.snapshot.element[].binding.description
The clinical status of the condition or diagnosis.

# entry[].resource.snapshot.element[].comment
The data type is CodeableConcept because clinicalStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].isModifierReason
This element is labeled as a modifier because the status contains codes that mark the condition as no longer active.

# entry[].resource.snapshot.element[].short
active | recurrence | relapse | inactive | remission | resolved

# entry[].resource.snapshot.element[].binding.description
The verification status to support or decline the clinical status of the condition or diagnosis.

# entry[].resource.snapshot.element[].comment
verificationStatus is not required.  For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status.
The data type is CodeableConcept because verificationStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The verification status to support the clinical status of the condition.

# entry[].resource.snapshot.element[].isModifierReason
This element is labeled as a modifier because the status contains the code refuted and entered-in-error that mark the Condition as not currently valid.

# entry[].resource.snapshot.element[].short
unconfirmed | provisional | differential | confirmed | refuted | entered-in-error

# entry[].resource.snapshot.element[].comment
The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].mapping[].map
'problem' if from PRB-3. 'diagnosis' if from DG1 segment in PV1 message

# entry[].resource.snapshot.element[].binding.description
A subjective assessment of the severity of the condition as evaluated by the clinician.

# entry[].resource.snapshot.element[].comment
Coding of the severity with a terminology is preferred, where possible.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A subjective assessment of the severity of the condition as evaluated by the clinician.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Identification of the condition, problem or diagnosis.

# entry[].resource.snapshot.element[].mapping[].map
code 246090004 |Associated finding| (< 404684003 |Clinical finding| MINUS
<< 420134006 |Propensity to adverse reactions| MINUS 
<< 473010000 |Hypersensitivity condition| MINUS 
<< 79899007 |Drug interaction| MINUS
<< 69449002 |Drug action| MINUS 
<< 441742003 |Evaluation finding| MINUS 
<< 307824009 |Administrative status| MINUS 
<< 385356007 |Tumor stage finding|) 
OR < 413350009 |Finding with explicit context|
OR < 272379006 |Event|

# entry[].resource.snapshot.element[].requirements
0..1 to account for primarily narrative only resources.

# entry[].resource.snapshot.element[].short
Identification of the condition, problem or diagnosis

# entry[].resource.snapshot.element[].binding.description
Codes describing anatomical locations. May include laterality.

# entry[].resource.snapshot.element[].comment
Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [bodySite](http://hl7.org/fhir/R4/extension-bodysite.html).  May be a summary code, or a reference to a very precise definition of the location, or both.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The anatomical location where this condition manifests itself.

# entry[].resource.snapshot.element[].mapping[].map
< 442083009  |Anatomical or acquired body structure|

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Indicates the patient or group who the condition record is associated with.

# entry[].resource.snapshot.element[].requirements
Group is typically used for veterinary or public health use cases.

# entry[].resource.snapshot.element[].comment
This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. This record indicates the encounter this particular record is associated with.  In the case of a "new" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first "known".

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The Encounter during which this Condition was created or to which the creation of this record is tightly associated.

# entry[].resource.snapshot.element[].comment
Age is generally used when the patient reports an age at which the Condition began to occur.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Estimated or actual date or date-time  the condition began, in the opinion of the clinician.

# entry[].resource.snapshot.element[].short
Estimated or actual date,  date-time, or age

# entry[].resource.snapshot.element[].comment
There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated.  If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid.  When abatementString exists, it implies the condition is abated.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The date or estimated date that the condition resolved or went into remission. This is called "abatement" because of the many overloaded connotations associated with "remission" or "resolution" - Conditions are never really resolved, but they can abate.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The recordedDate represents when this particular Condition record was created in the system, which is often a system-generated date.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Individual who recorded the record and takes responsibility for its content.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Individual who is making the condition statement.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Clinical stage or grade of a condition. May include formal severity assessments.

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].binding.description
Codes describing condition stages (e.g. Cancer stages).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A simple summary of the stage such as "Stage 3". The determination of the stage is disease-specific.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Reference to a formal record of the evidence on which the staging assessment is based.

# entry[].resource.snapshot.element[].binding.description
Codes describing the kind of condition staging (e.g. clinical or pathological).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The kind of staging, such as pathological or clinical staging.

# entry[].resource.snapshot.element[].comment
The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Supporting evidence / manifestations that are the basis of the Condition's verification status, such as evidence that confirmed or refuted the condition.

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].binding.description
Codes that describe the manifestation or symptoms of a condition.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A manifestation or symptom that led to the recording of this condition.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Links to other relevant information, including pathology reports.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Additional information about the Condition. This is a general notes/comments entry  for description of the Condition, its diagnosis and prognosis.

# entry[].resource.snapshot.element[].short
Additional information about the Condition

# entry[].resource.text.div
Name | Flags | Card. | Type | Description & Constraints
Condition | | 0..* | Condition | Detailed information about conditions, problems or diagnoses

code

0..1

CodeableConcept

Identification of the condition, problem or diagnosis
Binding: Phenotype Codes (required)

Documentation for this format

# entry[].resource.description
Representation for a disease under study for a given research dataset.

# entry[].resource.snapshot.element[].definition
A clinical condition, problem, diagnosis, or other event, situation, issue, or clinical concept that has risen to a level of concern.

# entry[].resource.snapshot.element[].mapping[].map
< 243796009 |Situation with explicit context| : 246090004 |Associated finding| = ( ( < 404684003 |Clinical finding| MINUS ( << 420134006 |Propensity to adverse reactions| OR << 473010000 |Hypersensitivity condition| OR << 79899007 |Drug interaction| OR << 69449002 |Drug action| OR << 441742003 |Evaluation finding| OR << 307824009 |Administrative status| OR << 385356007 |Tumor stage finding|)) OR < 272379006 |Event|)

# entry[].resource.snapshot.element[].short
Detailed information about conditions, problems or diagnoses

# entry[].resource.snapshot.element[].comment
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

# entry[].resource.snapshot.element[].definition
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

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

# entry[].resource.snapshot.element[].isModifierReason
This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation

# entry[].resource.snapshot.element[].short
A set of rules under which this content was created

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The base language in which the resource is written.

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

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

# entry[].resource.snapshot.element[].short
Text summary of the resource, for human interpretation

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

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].comment
This is a business identifier, not a resource identifier (see [discussion](http://hl7.org/fhir/R4/resource.html#identifiers)).  It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types.  For example, multiple Patient and a Person resource instance might share the same social insurance number.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Business identifiers assigned to this condition by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

# entry[].resource.snapshot.element[].requirements
Allows identification of the condition as it is known by various participating systems and in a way that remains consistent across servers.

# entry[].resource.snapshot.element[].binding.description
The clinical status of the condition or diagnosis.

# entry[].resource.snapshot.element[].comment
The data type is CodeableConcept because clinicalStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].isModifierReason
This element is labeled as a modifier because the status contains codes that mark the condition as no longer active.

# entry[].resource.snapshot.element[].short
active | recurrence | relapse | inactive | remission | resolved

# entry[].resource.snapshot.element[].binding.description
The verification status to support or decline the clinical status of the condition or diagnosis.

# entry[].resource.snapshot.element[].comment
verificationStatus is not required.  For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status.
The data type is CodeableConcept because verificationStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The verification status to support the clinical status of the condition.

# entry[].resource.snapshot.element[].isModifierReason
This element is labeled as a modifier because the status contains the code refuted and entered-in-error that mark the Condition as not currently valid.

# entry[].resource.snapshot.element[].short
unconfirmed | provisional | differential | confirmed | refuted | entered-in-error

# entry[].resource.snapshot.element[].comment
The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].mapping[].map
'problem' if from PRB-3. 'diagnosis' if from DG1 segment in PV1 message

# entry[].resource.snapshot.element[].binding.description
A subjective assessment of the severity of the condition as evaluated by the clinician.

# entry[].resource.snapshot.element[].comment
Coding of the severity with a terminology is preferred, where possible.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A subjective assessment of the severity of the condition as evaluated by the clinician.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Identification of the condition, problem or diagnosis.

# entry[].resource.snapshot.element[].mapping[].map
code 246090004 |Associated finding| (< 404684003 |Clinical finding| MINUS
<< 420134006 |Propensity to adverse reactions| MINUS 
<< 473010000 |Hypersensitivity condition| MINUS 
<< 79899007 |Drug interaction| MINUS
<< 69449002 |Drug action| MINUS 
<< 441742003 |Evaluation finding| MINUS 
<< 307824009 |Administrative status| MINUS 
<< 385356007 |Tumor stage finding|) 
OR < 413350009 |Finding with explicit context|
OR < 272379006 |Event|

# entry[].resource.snapshot.element[].requirements
0..1 to account for primarily narrative only resources.

# entry[].resource.snapshot.element[].short
Identification of the condition, problem or diagnosis

# entry[].resource.snapshot.element[].binding.description
Codes describing anatomical locations. May include laterality.

# entry[].resource.snapshot.element[].comment
Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [bodySite](http://hl7.org/fhir/R4/extension-bodysite.html).  May be a summary code, or a reference to a very precise definition of the location, or both.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The anatomical location where this condition manifests itself.

# entry[].resource.snapshot.element[].mapping[].map
< 442083009  |Anatomical or acquired body structure|

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Indicates the patient or group who the condition record is associated with.

# entry[].resource.snapshot.element[].requirements
Group is typically used for veterinary or public health use cases.

# entry[].resource.snapshot.element[].comment
This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. This record indicates the encounter this particular record is associated with.  In the case of a "new" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first "known".

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The Encounter during which this Condition was created or to which the creation of this record is tightly associated.

# entry[].resource.snapshot.element[].comment
Age is generally used when the patient reports an age at which the Condition began to occur.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Estimated or actual date or date-time  the condition began, in the opinion of the clinician.

# entry[].resource.snapshot.element[].short
Estimated or actual date,  date-time, or age

# entry[].resource.snapshot.element[].comment
There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated.  If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid.  When abatementString exists, it implies the condition is abated.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The date or estimated date that the condition resolved or went into remission. This is called "abatement" because of the many overloaded connotations associated with "remission" or "resolution" - Conditions are never really resolved, but they can abate.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The recordedDate represents when this particular Condition record was created in the system, which is often a system-generated date.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Individual who recorded the record and takes responsibility for its content.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Individual who is making the condition statement.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Clinical stage or grade of a condition. May include formal severity assessments.

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].binding.description
Codes describing condition stages (e.g. Cancer stages).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A simple summary of the stage such as "Stage 3". The determination of the stage is disease-specific.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Reference to a formal record of the evidence on which the staging assessment is based.

# entry[].resource.snapshot.element[].binding.description
Codes describing the kind of condition staging (e.g. clinical or pathological).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The kind of staging, such as pathological or clinical staging.

# entry[].resource.snapshot.element[].comment
The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Supporting evidence / manifestations that are the basis of the Condition's verification status, such as evidence that confirmed or refuted the condition.

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].binding.description
Codes that describe the manifestation or symptoms of a condition.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A manifestation or symptom that led to the recording of this condition.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Links to other relevant information, including pathology reports.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Additional information about the Condition. This is a general notes/comments entry  for description of the Condition, its diagnosis and prognosis.

# entry[].resource.snapshot.element[].short
Additional information about the Condition

# entry[].resource.text.div
Name | Flags | Card. | Type | Description & Constraints
Condition | | 0..* | Condition | Detailed information about conditions, problems or diagnoses

code

0..1

CodeableConcept

Identification of the condition, problem or diagnosis
Binding: Disease Codes (extensible)

Documentation for this format

# entry[].resource.description
A FHIR analysis task that takes at least one specimen as input and produces at least one document.

# entry[].resource.snapshot.element[].comment
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

# entry[].resource.snapshot.element[].definition
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

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

# entry[].resource.snapshot.element[].isModifierReason
This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation

# entry[].resource.snapshot.element[].short
A set of rules under which this content was created

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The base language in which the resource is written.

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

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

# entry[].resource.snapshot.element[].short
Text summary of the resource, for human interpretation

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

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The URL pointing to a *FHIR*-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this Task.

# entry[].resource.snapshot.element[].requirements
Enables a formal definition of how he task is to be performed, enabling automation.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The URL pointing to an *externally* maintained  protocol, guideline, orderset or other definition that is adhered to in whole or in part by this Task.

# entry[].resource.snapshot.element[].requirements
Enables a formal definition of how he task is to be performed (e.g. using BPMN, BPEL, XPDL or other formal notation to be associated with a task), enabling automation.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
BasedOn refers to a higher-level authorization that triggered the creation of the task.  It references a "request" resource such as a ServiceRequest, MedicationRequest, ServiceRequest, CarePlan, etc. which is distinct from the "request" resource the task is seeking to fulfill.  This latter resource is referenced by FocusOn.  For example, based on a ServiceRequest (= BasedOn), a task is created to fulfill a procedureRequest ( = FocusOn ) to collect a specimen from a patient.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
An identifier that links together multiple tasks and other requests that were created in the same context.

# entry[].resource.snapshot.element[].requirements
Billing and/or reporting can be linked to whether multiple requests were created as a single unit.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Task that this particular task is part of.

# entry[].resource.snapshot.element[].requirements
Allows tasks to be broken down into sub-steps (and this division can occur independent of the original task).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].isModifierReason
This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid

# entry[].resource.snapshot.element[].requirements
These states enable coordination of task status with off-the-shelf workflow solutions that support automation of tasks.

# entry[].resource.snapshot.element[].short
draft | requested | received | accepted | +

# entry[].resource.snapshot.element[].binding.description
Codes to identify the reason for current status.  These will typically be specific to a particular workflow.

# entry[].resource.snapshot.element[].comment
This applies to the current status.  Look at the history of the task to see reasons for past statuses.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
An explanation as to why this task is held, failed, was refused, etc.

# entry[].resource.snapshot.element[].binding.description
The domain-specific business-contextual sub-state of the task.  For example: "Blood drawn", "IV inserted", "Awaiting physician signature", etc.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Contains business-specific nuances of the business state.

# entry[].resource.snapshot.element[].requirements
There's often a need to track substates of a task - this is often variable by specific workflow implementation.

# entry[].resource.snapshot.element[].binding.description
Distinguishes whether the task is a proposal, plan or full order.

# entry[].resource.snapshot.element[].comment
This element is immutable.  Proposed tasks, planned tasks, etc. must be distinct instances.

In most cases, Tasks will have an intent of "order".

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Indicates the "level" of actionability associated with the Task, i.e. i+R[9]Cs this a proposed task, a planned task, an actionable task, etc.

# entry[].resource.snapshot.element[].short
unknown | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Indicates how quickly the Task should be addressed with respect to other requests.

# entry[].resource.snapshot.element[].meaningWhenMissing
If missing, this task should be performed with normal priority

# entry[].resource.snapshot.element[].requirements
Used to identify the service level expected while performing a task.

# entry[].resource.snapshot.element[].binding.description
Codes to identify what the task involves.  These will typically be specific to a particular workflow.

# entry[].resource.snapshot.element[].comment
The title (eg "My Tasks", "Outstanding Tasks for Patient X") should go into the code.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A name or code (or both) briefly describing what the task involves.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A free-text description of what is to be performed.

# entry[].resource.snapshot.element[].comment
If multiple resources need to be manipulated, use sub-tasks.  (This ensures that status can be tracked independently for each referenced resource.).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The request being actioned or the resource being manipulated by this task.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The entity who benefits from the performance of the service specified in the task (e.g., the patient).

# entry[].resource.snapshot.element[].requirements
Used to track tasks outstanding for a beneficiary.  Do not use to track the task owner or creator (see owner and creator respectively).  This can also affect access control.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The healthcare event  (e.g. a patient and healthcare provider interaction) during which this task was created.

# entry[].resource.snapshot.element[].requirements
For some tasks it may be important to know the link between the encounter the task originated within.

# entry[].resource.snapshot.element[].short
Healthcare event during which this task originated

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Identifies the time action was first taken against the task (start) and/or the time final action was taken against the task prior to marking it as completed (end).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The date and time this task was created.

# entry[].resource.snapshot.element[].requirements
Most often used along with lastUpdated to track duration of task to supporting monitoring and management.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The date and time of last modification to this task.

# entry[].resource.snapshot.element[].requirements
Used along with history to track task activity and time in a particular task state.  This enables monitoring and management.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].requirements
Identifies who created this task.  May be used by access control mechanisms (e.g., to ensure that only the creator can cancel a task).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The kind of participant that should perform the task.

# entry[].resource.snapshot.element[].requirements
Use to distinguish tasks on different activity queues.

# entry[].resource.snapshot.element[].comment
Tasks may be created with an owner not yet identified.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Individual organization or Device currently responsible for task execution.

# entry[].resource.snapshot.element[].requirements
Identifies who is expected to perform this task.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Principal physical location where the this task is performed.

# entry[].resource.snapshot.element[].requirements
Ties the event to where the records are likely kept and provides context around the event occurrence (e.g. if it occurred inside or outside a dedicated healthcare setting).

# entry[].resource.snapshot.element[].binding.description
Indicates why the task is needed.  E.g. Suspended because patient admitted to hospital.

# entry[].resource.snapshot.element[].comment
This should only be included if there is no focus or if it differs from the reason indicated on the focus.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A description or code indicating why this task needs to be performed.

# entry[].resource.snapshot.element[].comment
Tasks might be justified based on an Observation, a Condition, a past or planned procedure, etc.   This should only be included if there is no focus or if it differs from the reason indicated on the focus.    Use the CodeableConcept text element in `Task.reasonCode` if the data is free (uncoded) text.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A resource reference indicating why this task needs to be performed.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be relevant to the Task.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Free-text information captured about the task as it progresses.

# entry[].resource.snapshot.element[].comment
This element does not point to the Provenance associated with the *current* version of the resource - as it would be created after this version existed.  The Provenance for the current version can be retrieved with a _revinclude.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Links to Provenance records for past versions of this Task that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the task.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
If the Task.focus is a request resource and the task is seeking fulfillment (i.e. is asking for the request to be actioned), this element identifies any limitations on what parts of the referenced request should be actioned.

# entry[].resource.snapshot.element[].mapping[].map
Instead of pointing to request, would point to component of request, having these characteristics

# entry[].resource.snapshot.element[].requirements
Sometimes when fulfillment is sought, you don't want full fulfillment.

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Indicates the number of times the requested action should occur.

# entry[].resource.snapshot.element[].requirements
E.g. order that requests monthly lab tests, fulfillment is sought for 1.

# entry[].resource.snapshot.element[].comment
Note that period.high is the due date representing the time by which the task should be completed.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Over what time-period is fulfillment sought.

# entry[].resource.snapshot.element[].requirements
E.g. order that authorizes 1 year's services.  Fulfillment is sought for next 3 months.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
For requests that are targeted to more than on potential recipient/target, for whom is fulfillment sought?

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Additional information that may be needed in the execution of the task.

# entry[].resource.snapshot.element[].requirements
Resources and data used to perform the task.  This data is used in the business logic of task execution, and is stored separately because it varies between workflows.

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].binding.description
Codes to identify types of input parameters.  These will typically be specific to a particular workflow.  E.g. "Comparison source", "Applicable consent", "Concomitent Medications", etc.

# entry[].resource.snapshot.element[].comment
If referencing a BPMN workflow or Protocol, the "system" is the URL for the workflow definition and the code is the "name" of the required input.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A code or description indicating how the input is intended to be used as part of the task execution.

# entry[].resource.snapshot.element[].requirements
Inputs are named to enable task automation to bind data and pass it from one task to the next.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The value of the input parameter as a basic type.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].requirements
Resources and data produced during the execution the task.  This data is generated by the business logic of task execution, and is stored separately because it varies between workflows.

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].binding.description
Codes to identify types of input parameters.  These will typically be specific to a particular workflow.  E.g. "Identified issues", "Preliminary results", "Filler order", "Final results", etc.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].requirements
Outputs are named to enable task automation to bind data and pass it from one task to the next.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The value of the Output parameter as a basic type.

# entry[].resource.text.div
Name | Flags | Card. | Type | Description & Constraints
Task | | 0..* | Task | A task to be performed
focus | | 1..1 | Reference(Specimen) | What task is acting on
for | | 1..1 | Reference(Patient) | Beneficiary of the Task
owner | | 1..1 | Reference(Organization) | Responsible individual

Documentation for this format

# entry[].resource.description
An observation containing summary data associated with research data from FHIR.

# entry[].resource.snapshot.element[].comment
Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as laboratory reports, etc.

# entry[].resource.snapshot.element[].definition
Measurements and simple assertions made about a patient, device or other subject.

# entry[].resource.snapshot.element[].comment
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

# entry[].resource.snapshot.element[].definition
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

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

# entry[].resource.snapshot.element[].isModifierReason
This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation

# entry[].resource.snapshot.element[].short
A set of rules under which this content was created

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The base language in which the resource is written.

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

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

# entry[].resource.snapshot.element[].short
Text summary of the resource, for human interpretation

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

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A unique identifier assigned to this observation.

# entry[].resource.snapshot.element[].mapping[].map
OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4.

# entry[].resource.snapshot.element[].requirements
Allows observations to be distinguished and referenced.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A plan, proposal or order that is fulfilled in whole or in part by this event.  For example, a MedicationRequest may require a patient to have laboratory test performed before  it is dispensed.

# entry[].resource.snapshot.element[].requirements
Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.

# entry[].resource.snapshot.element[].comment
To link an Observation to an Encounter use `encounter`.  See the  [Notes](http://hl7.org/fhir/R4/observation.html#obsgrouping) below for guidance on referencing another Observation.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A larger event of which this particular Observation is a component or step.  For example,  an observation as part of a procedure.

# entry[].resource.snapshot.element[].binding.description
Codes providing the status of an observation.

# entry[].resource.snapshot.element[].comment
This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].isModifierReason
This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid

# entry[].resource.snapshot.element[].mapping[].map
status  Amended & Final are differentiated by whether it is the subject of a ControlAct event with a type of "revise"

# entry[].resource.snapshot.element[].requirements
Need to track the status of individual results. Some results are finalized before the whole report is finalized.

# entry[].resource.snapshot.element[].short
registered | preliminary | final | amended +

# entry[].resource.snapshot.element[].binding.description
Codes for high level observation categories.

# entry[].resource.snapshot.element[].comment
In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A code that classifies the general type of observation being made.

# entry[].resource.snapshot.element[].requirements
Used for filtering what observations are retrieved and displayed.

# entry[].resource.snapshot.element[].binding.description
Codes identifying names of simple observations.

# entry[].resource.snapshot.element[].comment
*All* code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Describes what was observed. Sometimes this is called the observation "name".

# entry[].resource.snapshot.element[].mapping[].map
< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|

# entry[].resource.snapshot.element[].requirements
Knowing what kind of observation is being made is essential to understanding the observation.

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

# entry[].resource.snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# entry[].resource.snapshot.element[].comment
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A reference to a code defined by a terminology system.

# entry[].resource.snapshot.element[].requirements
Allows for alternative encodings within a code system, and translations to other code systems.

# entry[].resource.snapshot.element[].comment
Very often the text is the same as a displayName of one of the codings.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

# entry[].resource.snapshot.element[].mapping[].map
C*E.9. But note many systems use C*E.2 for this

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

# entry[].resource.snapshot.element[].short
Plain text representation of the concept

# entry[].resource.snapshot.element[].comment
One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The patient, or group of patients, location, or device this observation is about and into whose record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the `focus` element or the `code` itself specifies the actual focus of the observation.

# entry[].resource.snapshot.element[].requirements
Observations have no value if you don't know who or what they're about.

# entry[].resource.snapshot.element[].short
Who and/or what the observation is about

# entry[].resource.snapshot.element[].comment
Typically, an observation is made about the subject - a patient, or group of patients, location, or device - and the distinction between the subject and what is directly measured for an observation is specified in the observation code itself ( e.g., "Blood Glucose") and does not need to be represented separately using this element.  Use `specimen` if a reference to a specimen is required.  If a code is required instead of a resource use either  `bodysite` for bodysites or the standard extension [focusCode](http://hl7.org/fhir/R4/extension-observation-focuscode.html).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The actual focus of an observation when it is not the patient of record representing something or someone associated with the patient such as a spouse, parent, fetus, or donor. For example, fetus observations in a mother's record.  The focus of an observation could also be an existing condition,  an intervention, the subject's diet,  another observation of the subject,  or a body structure such as tumor or implanted device.   An example use case would be using the Observation resource to capture whether the mother is trained to change her child's tracheostomy tube. In this example, the child is the patient of record and the mother is the focus.

# entry[].resource.snapshot.element[].short
What the observation is about, when it is not about the subject of record

# entry[].resource.snapshot.element[].comment
This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.

# entry[].resource.snapshot.element[].requirements
For some observations it may be important to know the link between an observation and a particular encounter.

# entry[].resource.snapshot.element[].short
Healthcare event during which this observation is made

# entry[].resource.snapshot.element[].comment
At least a date should be present unless this observation is a historical report.  For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the [Timing](http://hl7.org/fhir/R4/datatypes.html#timing) datatype which allow the measurement to be tied to regular life events.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.

# entry[].resource.snapshot.element[].mapping[].map
OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)

# entry[].resource.snapshot.element[].requirements
Knowing when an observation was deemed true is important to its relevance as well as determining trends.

# entry[].resource.snapshot.element[].comment
For Observations that don’t require review and verification, it may be the same as the [`lastUpdated` ](http://hl7.org/fhir/R4/resource-definitions.html#Meta.lastUpdated) time of the resource itself.  For Observations that do require review and verification for certain updates, it might not be the same as the `lastUpdated` time of the resource itself due to a non-clinically significant update that doesn’t require the new version to be reviewed and verified again.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The date and time this version of the observation was made available to providers, typically after the results have been reviewed and verified.

# entry[].resource.snapshot.element[].mapping[].map
OBR.22 (or MSH.7), or perhaps OBX-19 (depends on who observation made)

# entry[].resource.snapshot.element[].short
Date/Time this version was made available

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Who was responsible for asserting the observed value as "true".

# entry[].resource.snapshot.element[].requirements
May give a degree of confidence in the observation and also indicates where follow-up questions should be directed.

# entry[].resource.snapshot.element[].comment
An observation may have; 1)  a single value here, 2)  both a value and a set of related or component values,  or 3)  only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code.  A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.  For additional guidance, see the [Notes section](http://hl7.org/fhir/R4/observation.html#notes) below.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The information determined as a result of making the observation, if the information has a simple value.

# entry[].resource.snapshot.element[].requirements
An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

# entry[].resource.snapshot.element[].comment
An observation may have; 1)  a single value here, 2)  both a value and a set of related or component values,  or 3)  only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code.  A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.  For additional guidance, see the [Notes section](http://hl7.org/fhir/R4/observation.html#notes) below.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The information determined as a result of making the observation, if the information has a simple value.

# entry[].resource.snapshot.element[].requirements
An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

# entry[].resource.snapshot.element[].binding.description
Codes specifying why the result (`Observation.value[x]`) is missing.

# entry[].resource.snapshot.element[].comment
Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  "detected", "not detected", "inconclusive", or  "specimen unsatisfactory".   

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Provides a reason why the expected value in the element Observation.value[x] is missing.

# entry[].resource.snapshot.element[].requirements
For many results it is necessary to handle exceptional values in measurements.

# entry[].resource.snapshot.element[].comment
Historically used for laboratory results (known as 'abnormal flag' ),  its use extends to other use cases where coded interpretations  are relevant.  Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A categorical assessment of an observation value.  For example, high, low, normal.

# entry[].resource.snapshot.element[].requirements
For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

# entry[].resource.snapshot.element[].comment
May include general statements about the observation, or statements about significant, unexpected or unreliable results values, or information about its source when relevant to its interpretation.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Comments about the observation or the results.

# entry[].resource.snapshot.element[].mapping[].map
NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)

# entry[].resource.snapshot.element[].requirements
Need to be able to provide free text additional information.

# entry[].resource.snapshot.element[].binding.description
Codes describing anatomical locations. May include laterality.

# entry[].resource.snapshot.element[].comment
Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   

If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ bodySite](http://hl7.org/fhir/R4/extension-bodysite.html).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Indicates the site on the subject's body where the observation was made (i.e. the target site).

# entry[].resource.snapshot.element[].comment
Only used if not implicit in code for Observation.code.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Indicates the mechanism used to perform the observation.

# entry[].resource.snapshot.element[].requirements
In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.

# entry[].resource.snapshot.element[].comment
Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The specimen that was used when this observation was made.

# entry[].resource.snapshot.element[].comment
Note that this is not meant to represent a device involved in the transmission of the result, e.g., a gateway.  Such devices may be documented using the Provenance resource where relevant.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The device used to generate the observation data.

# entry[].resource.snapshot.element[].comment
Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].expression
low.exists() or high.exists() or text.exists()

# entry[].resource.snapshot.element[].constraint[].human
Must have at least a low or a high or text

# entry[].resource.snapshot.element[].definition
Guidance on how to interpret the value by comparison to a normal or recommended range.  Multiple reference ranges are interpreted as an "OR".   In other words, to represent two distinct target populations, two `referenceRange` elements would be used.

# entry[].resource.snapshot.element[].requirements
Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The value of the low bound of the reference range.  The low bound of the reference range endpoint is inclusive of the value (e.g.  reference range is >=5 - <=9). If the low bound is omitted,  it is assumed to be meaningless (e.g. reference range is <=2.3).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The value of the high bound of the reference range.  The high bound of the reference range endpoint is inclusive of the value (e.g.  reference range is >=5 - <=9). If the high bound is omitted,  it is assumed to be meaningless (e.g. reference range is >= 2.3).

# entry[].resource.snapshot.element[].binding.description
Code for the meaning of a reference range.

# entry[].resource.snapshot.element[].comment
This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.

# entry[].resource.snapshot.element[].mapping[].map
< 260245000 |Findings values| OR  
< 365860008 |General clinical state finding| 
OR 
< 250171008 |Clinical history or observation findings| OR  
< 415229000 |Racial group| OR 
< 365400002 |Finding of puberty stage| OR
< 443938003 |Procedure carried out on subject|

# entry[].resource.snapshot.element[].requirements
Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc.,  - for proper interpretation.

# entry[].resource.snapshot.element[].binding.description
Codes identifying the population the reference range applies to.

# entry[].resource.snapshot.element[].comment
This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.  Multiple `appliesTo`  are interpreted as an "AND" of the target populations.  For example, to represent a target population of African American females, both a code of female and a code for African American would be used.

# entry[].resource.snapshot.element[].mapping[].map
< 260245000 |Findings values| OR  
< 365860008 |General clinical state finding| 
OR 
< 250171008 |Clinical history or observation findings| OR  
< 415229000 |Racial group| OR 
< 365400002 |Finding of puberty stage| OR
< 443938003 |Procedure carried out on subject|

# entry[].resource.snapshot.element[].requirements
Need to be able to identify the target population for proper interpretation.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The age at which this reference range is applicable. This is a neonatal age (e.g. number of weeks at term) if the meaning says so.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation.  An example would be a reference value of "Negative" or a list or table of "normals".

# entry[].resource.snapshot.element[].short
Text based reference range in an observation

# entry[].resource.snapshot.element[].comment
When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases.  For a discussion on the ways Observations can assembled in groups together, see [Notes](http://hl7.org/fhir/R4/observation.html#obsgrouping) below.  Note that a system may calculate results from [QuestionnaireResponse](http://hl7.org/fhir/R4/questionnaireresponse.html)  into a final score and represent the score as an Observation.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
This observation is a group observation (e.g. a battery, a panel of tests, a set of vital sign measurements) that includes the target as a member of the group.

# entry[].resource.snapshot.element[].mapping[].map
Relationships established by OBX-4 usage

# entry[].resource.snapshot.element[].short
Related resource that belongs to the Observation group

# entry[].resource.snapshot.element[].comment
All the reference choices that are listed in this element can represent clinical observations and other measurements that may be the source for a derived value.  The most common reference will be another Observation.  For a discussion on the ways Observations can assembled in groups together, see [Notes](http://hl7.org/fhir/R4/observation.html#obsgrouping) below.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image.

# entry[].resource.snapshot.element[].mapping[].map
Relationships established by OBX-4 usage

# entry[].resource.snapshot.element[].short
Related measurements the observation is made from

# entry[].resource.snapshot.element[].comment
For a discussion on the ways Observations can be assembled in groups together see [Notes](http://hl7.org/fhir/R4/observation.html#notes) below.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

# entry[].resource.snapshot.element[].requirements
Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].binding.description
Codes identifying names of simple observations.

# entry[].resource.snapshot.element[].comment
*All* code-value and  component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Describes what was observed. Sometimes this is called the observation "code".

# entry[].resource.snapshot.element[].mapping[].map
< 363787002 |Observable entity| OR 
< 386053000 |Evaluation procedure|

# entry[].resource.snapshot.element[].requirements
Knowing what kind of observation is being made is essential to understanding the observation.

# entry[].resource.snapshot.element[].short
Type of component observation (code / type)

# entry[].resource.snapshot.element[].comment
Used when observation has a set of component observations. An observation may have both a value (e.g. an  Apgar score)  and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.  For additional guidance, see the [Notes section](http://hl7.org/fhir/R4/observation.html#notes) below.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The information determined as a result of making the observation, if the information has a simple value.

# entry[].resource.snapshot.element[].requirements
An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

# entry[].resource.snapshot.element[].binding.description
Codes specifying why the result (`Observation.value[x]`) is missing.

# entry[].resource.snapshot.element[].comment
"Null" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  "detected", "not detected", "inconclusive", or  "test not done". 

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code "error" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Provides a reason why the expected value in the element Observation.component.value[x] is missing.

# entry[].resource.snapshot.element[].requirements
For many results it is necessary to handle exceptional values in measurements.

# entry[].resource.snapshot.element[].comment
Historically used for laboratory results (known as 'abnormal flag' ),  its use extends to other use cases where coded interpretations  are relevant.  Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A categorical assessment of an observation value.  For example, high, low, normal.

# entry[].resource.snapshot.element[].requirements
For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

# entry[].resource.snapshot.element[].comment
Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Guidance on how to interpret the value by comparison to a normal or recommended range.

# entry[].resource.snapshot.element[].requirements
Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

# entry[].resource.snapshot.element[].short
Provides guide for interpretation of component result

# entry[].resource.text.div
Name | Flags | Card. | Type | Description & Constraints
Observation | | 0..* | Observation | Measurements and simple assertions
code | | | |

coding

0..*

Coding

Code defined by a terminology system
Required Pattern: At least the following

system

1..1

uri

Identity of the terminology system
Fixed Value: https://uts.nlm.nih.gov/uts/umls

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: C0242482

display

1..1

string

Representation defined by the system
Fixed Value: Summary Report

subject | | 0..1 | Reference(NCPI Study Group) | Who and/or what the observation is about
focus | | 1..* | Reference(NCPI Research Study) | What the observation is about, when it is not about the subject of record

value[x]

1..1

CodeableConcept

Actual result
Slice: Unordered, Open by type:$this

valueCodeableConcept | | 1..1 | CodeableConcept | Actual result
component | | 1..* | BackboneElement | Component results

Documentation for this format

# entry[].resource.differential.element[].constraint[].human
attachment.url must start with ^drs://. A drs:// hostname-based URI, as defined in the DRS documentation, that tells clients how to access this object. The intent of this field is to make DRS objects self-contained, and therefore easier for clients to store and pass around.  For example, if you arrive at this DRS JSON by resolving a compact identifier-based DRS URI, the `self_uri` presents you with a hostname and properly encoded DRS ID for use in subsequent `access` endpoint calls.

# entry[].resource.snapshot.element[].comment
When providing a summary view (for example with Observation.value[x]) Attachment should be represented with a brief display text such as "Signed Procedure Consent".

# entry[].resource.snapshot.element[].definition
For referring to data content defined in other formats.

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

# entry[].resource.snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# entry[].resource.snapshot.element[].binding.description
The mime type of an attachment. Any valid mime type is allowed.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Identifies the type of the data in the attachment and allows a method to be chosen to interpret or render the data. Includes mime type parameters such as charset where appropriate.

# entry[].resource.snapshot.element[].mapping[].map
ED.2+ED.3/RP.2+RP.3. Note conversion may be needed if old style values are being used

# entry[].resource.snapshot.element[].requirements
Processors of the data need to be able to know how to interpret the data.

# entry[].resource.snapshot.element[].short
Mime type of the content, with charset etc.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The human language of the content. The value can be any valid value according to BCP 47.

# entry[].resource.snapshot.element[].requirements
Users need to be able to choose between the languages in a set of attachments.

# entry[].resource.snapshot.element[].comment
The base64-encoded data SHALL be expressed in the same character set as the base resource XML or JSON.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The actual data of the attachment - a sequence of bytes, base64 encoded.

# entry[].resource.snapshot.element[].requirements
The data needs to able to be transmitted inline.

# entry[].resource.snapshot.element[].comment
If both data and url are provided, the url SHALL point to the same content as the data contains. Urls may be relative references or may reference transient locations such as a wrapping envelope using cid: though this has ramifications for using signatures. Relative URLs are interpreted relative to the service url, like a resource reference, rather than relative to the resource itself. If a URL is provided, it SHALL resolve to actual data.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A location where the data can be accessed.

# entry[].resource.snapshot.element[].mapping[].map
RP.1+RP.2 - if they refer to a URL (see v2.6)

# entry[].resource.snapshot.element[].requirements
The data needs to be transmitted by reference.

# entry[].resource.snapshot.element[].comment
The number of bytes is redundant if the data is provided as a base64binary, but is useful if the data is provided as a url reference.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The number of bytes of data that make up this attachment (before base64 encoding, if that is done).

# entry[].resource.snapshot.element[].requirements
Representing the size allows applications to determine whether they should fetch the content automatically in advance, or refuse to fetch it at all.

# entry[].resource.snapshot.element[].short
Number of bytes of content (if url provided)

# entry[].resource.snapshot.element[].comment
The hash is calculated on the data prior to base64 encoding, if the data is based64 encoded. The hash is not intended to support digital signatures. Where protection against malicious threats a digital signature should be considered, see [Provenance.signature](http://hl7.org/fhir/R4/provenance-definitions.html#Provenance.signature) for mechanism to protect a resource with a digital signature.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The calculated hash of the data using SHA-1. Represented using base64.

# entry[].resource.snapshot.element[].requirements
Included so that applications can verify that the contents of a location have not changed due to technical failures (e.g., storage rot, transport glitch, incorrect version).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A label or set of text to display in place of the data.

# entry[].resource.snapshot.element[].requirements
Applications need a label to display to a human user in place of the actual data if the data cannot be rendered or perceived by the viewer.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The date that the attachment was first created.

# entry[].resource.snapshot.element[].requirements
This is often tracked as an integrity issue for use of the attachment.

# entry[].resource.text.div
Name | Flags | Card. | Type | Description & Constraints

Attachment

C

0..*

Attachment

Content in a format defined elsewhere
must-be-drs-uri: attachment.url must start with ^drs://. A drs:// hostname-based URI, as defined in the DRS documentation, that tells clients how to access this object. The intent of this field is to make DRS objects self-contained, and therefore easier for clients to store and pass around. For example, if you arrive at this DRS JSON by resolving a compact identifier-based DRS URI, the `self_uri` presents you with a hostname and properly encoded DRS ID for use in subsequent `access` endpoint calls.

Documentation for this format

# entry[].resource.description
Representation of a family relationship.

# entry[].resource.snapshot.element[].comment
Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as laboratory reports, etc.

# entry[].resource.snapshot.element[].definition
Measurements and simple assertions made about a patient, device or other subject.

# entry[].resource.snapshot.element[].comment
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

# entry[].resource.snapshot.element[].definition
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

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

# entry[].resource.snapshot.element[].isModifierReason
This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation

# entry[].resource.snapshot.element[].short
A set of rules under which this content was created

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The base language in which the resource is written.

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

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

# entry[].resource.snapshot.element[].short
Text summary of the resource, for human interpretation

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

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A unique identifier assigned to this observation.

# entry[].resource.snapshot.element[].mapping[].map
OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4.

# entry[].resource.snapshot.element[].requirements
Allows observations to be distinguished and referenced.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A plan, proposal or order that is fulfilled in whole or in part by this event.  For example, a MedicationRequest may require a patient to have laboratory test performed before  it is dispensed.

# entry[].resource.snapshot.element[].requirements
Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.

# entry[].resource.snapshot.element[].comment
To link an Observation to an Encounter use `encounter`.  See the  [Notes](http://hl7.org/fhir/R4/observation.html#obsgrouping) below for guidance on referencing another Observation.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A larger event of which this particular Observation is a component or step.  For example,  an observation as part of a procedure.

# entry[].resource.snapshot.element[].binding.description
Codes providing the status of an observation.

# entry[].resource.snapshot.element[].comment
This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].isModifierReason
This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid

# entry[].resource.snapshot.element[].mapping[].map
status  Amended & Final are differentiated by whether it is the subject of a ControlAct event with a type of "revise"

# entry[].resource.snapshot.element[].requirements
Need to track the status of individual results. Some results are finalized before the whole report is finalized.

# entry[].resource.snapshot.element[].short
registered | preliminary | final | amended +

# entry[].resource.snapshot.element[].binding.description
Codes for high level observation categories.

# entry[].resource.snapshot.element[].comment
In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A code that classifies the general type of observation being made.

# entry[].resource.snapshot.element[].requirements
Used for filtering what observations are retrieved and displayed.

# entry[].resource.snapshot.element[].binding.description
Codes identifying names of simple observations.

# entry[].resource.snapshot.element[].comment
*All* code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Describes what was observed. Sometimes this is called the observation "name".

# entry[].resource.snapshot.element[].mapping[].map
< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|

# entry[].resource.snapshot.element[].requirements
Knowing what kind of observation is being made is essential to understanding the observation.

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

# entry[].resource.snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# entry[].resource.snapshot.element[].comment
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A reference to a code defined by a terminology system.

# entry[].resource.snapshot.element[].requirements
Allows for alternative encodings within a code system, and translations to other code systems.

# entry[].resource.snapshot.element[].comment
Very often the text is the same as a displayName of one of the codings.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

# entry[].resource.snapshot.element[].mapping[].map
C*E.9. But note many systems use C*E.2 for this

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

# entry[].resource.snapshot.element[].short
Plain text representation of the concept

# entry[].resource.snapshot.element[].comment
One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The patient, or group of patients, location, or device this observation is about and into whose record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the `focus` element or the `code` itself specifies the actual focus of the observation.

# entry[].resource.snapshot.element[].requirements
Observations have no value if you don't know who or what they're about.

# entry[].resource.snapshot.element[].short
Who and/or what the observation is about

# entry[].resource.snapshot.element[].comment
Typically, an observation is made about the subject - a patient, or group of patients, location, or device - and the distinction between the subject and what is directly measured for an observation is specified in the observation code itself ( e.g., "Blood Glucose") and does not need to be represented separately using this element.  Use `specimen` if a reference to a specimen is required.  If a code is required instead of a resource use either  `bodysite` for bodysites or the standard extension [focusCode](http://hl7.org/fhir/R4/extension-observation-focuscode.html).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The actual focus of an observation when it is not the patient of record representing something or someone associated with the patient such as a spouse, parent, fetus, or donor. For example, fetus observations in a mother's record.  The focus of an observation could also be an existing condition,  an intervention, the subject's diet,  another observation of the subject,  or a body structure such as tumor or implanted device.   An example use case would be using the Observation resource to capture whether the mother is trained to change her child's tracheostomy tube. In this example, the child is the patient of record and the mother is the focus.

# entry[].resource.snapshot.element[].short
What the observation is about, when it is not about the subject of record

# entry[].resource.snapshot.element[].comment
This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.

# entry[].resource.snapshot.element[].requirements
For some observations it may be important to know the link between an observation and a particular encounter.

# entry[].resource.snapshot.element[].short
Healthcare event during which this observation is made

# entry[].resource.snapshot.element[].comment
At least a date should be present unless this observation is a historical report.  For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the [Timing](http://hl7.org/fhir/R4/datatypes.html#timing) datatype which allow the measurement to be tied to regular life events.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.

# entry[].resource.snapshot.element[].mapping[].map
OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)

# entry[].resource.snapshot.element[].requirements
Knowing when an observation was deemed true is important to its relevance as well as determining trends.

# entry[].resource.snapshot.element[].comment
For Observations that don’t require review and verification, it may be the same as the [`lastUpdated` ](http://hl7.org/fhir/R4/resource-definitions.html#Meta.lastUpdated) time of the resource itself.  For Observations that do require review and verification for certain updates, it might not be the same as the `lastUpdated` time of the resource itself due to a non-clinically significant update that doesn’t require the new version to be reviewed and verified again.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The date and time this version of the observation was made available to providers, typically after the results have been reviewed and verified.

# entry[].resource.snapshot.element[].mapping[].map
OBR.22 (or MSH.7), or perhaps OBX-19 (depends on who observation made)

# entry[].resource.snapshot.element[].short
Date/Time this version was made available

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Who was responsible for asserting the observed value as "true".

# entry[].resource.snapshot.element[].requirements
May give a degree of confidence in the observation and also indicates where follow-up questions should be directed.

# entry[].resource.snapshot.element[].comment
An observation may have; 1)  a single value here, 2)  both a value and a set of related or component values,  or 3)  only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code.  A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.  For additional guidance, see the [Notes section](http://hl7.org/fhir/R4/observation.html#notes) below.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The information determined as a result of making the observation, if the information has a simple value.

# entry[].resource.snapshot.element[].requirements
An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

# entry[].resource.snapshot.element[].comment
An observation may have; 1)  a single value here, 2)  both a value and a set of related or component values,  or 3)  only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code.  A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.  For additional guidance, see the [Notes section](http://hl7.org/fhir/R4/observation.html#notes) below.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The information determined as a result of making the observation, if the information has a simple value.

# entry[].resource.snapshot.element[].requirements
An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

# entry[].resource.snapshot.element[].binding.description
Codes specifying why the result (`Observation.value[x]`) is missing.

# entry[].resource.snapshot.element[].comment
Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  "detected", "not detected", "inconclusive", or  "specimen unsatisfactory".   

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Provides a reason why the expected value in the element Observation.value[x] is missing.

# entry[].resource.snapshot.element[].requirements
For many results it is necessary to handle exceptional values in measurements.

# entry[].resource.snapshot.element[].comment
Historically used for laboratory results (known as 'abnormal flag' ),  its use extends to other use cases where coded interpretations  are relevant.  Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A categorical assessment of an observation value.  For example, high, low, normal.

# entry[].resource.snapshot.element[].requirements
For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

# entry[].resource.snapshot.element[].comment
May include general statements about the observation, or statements about significant, unexpected or unreliable results values, or information about its source when relevant to its interpretation.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Comments about the observation or the results.

# entry[].resource.snapshot.element[].mapping[].map
NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)

# entry[].resource.snapshot.element[].requirements
Need to be able to provide free text additional information.

# entry[].resource.snapshot.element[].binding.description
Codes describing anatomical locations. May include laterality.

# entry[].resource.snapshot.element[].comment
Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   

If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ bodySite](http://hl7.org/fhir/R4/extension-bodysite.html).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Indicates the site on the subject's body where the observation was made (i.e. the target site).

# entry[].resource.snapshot.element[].comment
Only used if not implicit in code for Observation.code.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Indicates the mechanism used to perform the observation.

# entry[].resource.snapshot.element[].requirements
In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.

# entry[].resource.snapshot.element[].comment
Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The specimen that was used when this observation was made.

# entry[].resource.snapshot.element[].comment
Note that this is not meant to represent a device involved in the transmission of the result, e.g., a gateway.  Such devices may be documented using the Provenance resource where relevant.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The device used to generate the observation data.

# entry[].resource.snapshot.element[].comment
Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].expression
low.exists() or high.exists() or text.exists()

# entry[].resource.snapshot.element[].constraint[].human
Must have at least a low or a high or text

# entry[].resource.snapshot.element[].definition
Guidance on how to interpret the value by comparison to a normal or recommended range.  Multiple reference ranges are interpreted as an "OR".   In other words, to represent two distinct target populations, two `referenceRange` elements would be used.

# entry[].resource.snapshot.element[].requirements
Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The value of the low bound of the reference range.  The low bound of the reference range endpoint is inclusive of the value (e.g.  reference range is >=5 - <=9). If the low bound is omitted,  it is assumed to be meaningless (e.g. reference range is <=2.3).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The value of the high bound of the reference range.  The high bound of the reference range endpoint is inclusive of the value (e.g.  reference range is >=5 - <=9). If the high bound is omitted,  it is assumed to be meaningless (e.g. reference range is >= 2.3).

# entry[].resource.snapshot.element[].binding.description
Code for the meaning of a reference range.

# entry[].resource.snapshot.element[].comment
This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.

# entry[].resource.snapshot.element[].mapping[].map
< 260245000 |Findings values| OR  
< 365860008 |General clinical state finding| 
OR 
< 250171008 |Clinical history or observation findings| OR  
< 415229000 |Racial group| OR 
< 365400002 |Finding of puberty stage| OR
< 443938003 |Procedure carried out on subject|

# entry[].resource.snapshot.element[].requirements
Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc.,  - for proper interpretation.

# entry[].resource.snapshot.element[].binding.description
Codes identifying the population the reference range applies to.

# entry[].resource.snapshot.element[].comment
This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.  Multiple `appliesTo`  are interpreted as an "AND" of the target populations.  For example, to represent a target population of African American females, both a code of female and a code for African American would be used.

# entry[].resource.snapshot.element[].mapping[].map
< 260245000 |Findings values| OR  
< 365860008 |General clinical state finding| 
OR 
< 250171008 |Clinical history or observation findings| OR  
< 415229000 |Racial group| OR 
< 365400002 |Finding of puberty stage| OR
< 443938003 |Procedure carried out on subject|

# entry[].resource.snapshot.element[].requirements
Need to be able to identify the target population for proper interpretation.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The age at which this reference range is applicable. This is a neonatal age (e.g. number of weeks at term) if the meaning says so.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation.  An example would be a reference value of "Negative" or a list or table of "normals".

# entry[].resource.snapshot.element[].short
Text based reference range in an observation

# entry[].resource.snapshot.element[].comment
When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases.  For a discussion on the ways Observations can assembled in groups together, see [Notes](http://hl7.org/fhir/R4/observation.html#obsgrouping) below.  Note that a system may calculate results from [QuestionnaireResponse](http://hl7.org/fhir/R4/questionnaireresponse.html)  into a final score and represent the score as an Observation.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
This observation is a group observation (e.g. a battery, a panel of tests, a set of vital sign measurements) that includes the target as a member of the group.

# entry[].resource.snapshot.element[].mapping[].map
Relationships established by OBX-4 usage

# entry[].resource.snapshot.element[].short
Related resource that belongs to the Observation group

# entry[].resource.snapshot.element[].comment
All the reference choices that are listed in this element can represent clinical observations and other measurements that may be the source for a derived value.  The most common reference will be another Observation.  For a discussion on the ways Observations can assembled in groups together, see [Notes](http://hl7.org/fhir/R4/observation.html#obsgrouping) below.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image.

# entry[].resource.snapshot.element[].mapping[].map
Relationships established by OBX-4 usage

# entry[].resource.snapshot.element[].short
Related measurements the observation is made from

# entry[].resource.snapshot.element[].comment
For a discussion on the ways Observations can be assembled in groups together see [Notes](http://hl7.org/fhir/R4/observation.html#notes) below.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

# entry[].resource.snapshot.element[].requirements
Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].binding.description
Codes identifying names of simple observations.

# entry[].resource.snapshot.element[].comment
*All* code-value and  component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Describes what was observed. Sometimes this is called the observation "code".

# entry[].resource.snapshot.element[].mapping[].map
< 363787002 |Observable entity| OR 
< 386053000 |Evaluation procedure|

# entry[].resource.snapshot.element[].requirements
Knowing what kind of observation is being made is essential to understanding the observation.

# entry[].resource.snapshot.element[].short
Type of component observation (code / type)

# entry[].resource.snapshot.element[].comment
Used when observation has a set of component observations. An observation may have both a value (e.g. an  Apgar score)  and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.  For additional guidance, see the [Notes section](http://hl7.org/fhir/R4/observation.html#notes) below.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The information determined as a result of making the observation, if the information has a simple value.

# entry[].resource.snapshot.element[].requirements
An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

# entry[].resource.snapshot.element[].binding.description
Codes specifying why the result (`Observation.value[x]`) is missing.

# entry[].resource.snapshot.element[].comment
"Null" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  "detected", "not detected", "inconclusive", or  "test not done". 

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code "error" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Provides a reason why the expected value in the element Observation.component.value[x] is missing.

# entry[].resource.snapshot.element[].requirements
For many results it is necessary to handle exceptional values in measurements.

# entry[].resource.snapshot.element[].comment
Historically used for laboratory results (known as 'abnormal flag' ),  its use extends to other use cases where coded interpretations  are relevant.  Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A categorical assessment of an observation value.  For example, high, low, normal.

# entry[].resource.snapshot.element[].requirements
For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

# entry[].resource.snapshot.element[].comment
Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Guidance on how to interpret the value by comparison to a normal or recommended range.

# entry[].resource.snapshot.element[].requirements
Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

# entry[].resource.snapshot.element[].short
Provides guide for interpretation of component result

# entry[].resource.text.div
Name | Flags | Card. | Type | Description & Constraints
Observation | | 0..* | Observation | Measurements and simple assertions

code

1..1

CodeableConcept

Type of observation (code / type)
Required Pattern: At least the following

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

system

1..1

uri

Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/v3-RoleCode

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: FAMMEMB

display

1..1

string

Representation defined by the system
Fixed Value: family member

text

0..1

string

Plain text representation of the concept
Required Pattern: Family Relationship

value[x]

0..1

CodeableConcept

Actual result
Slice: Unordered, Open by type:$this

valueCodeableConcept

0..1

CodeableConcept

Actual result
Binding: FamilyMember (extensible)

Documentation for this format

# entry[].resource.description
Representation for a row of data from one of the dataset's tables.

# entry[].resource.snapshot.element[].comment
Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as laboratory reports, etc.

# entry[].resource.snapshot.element[].definition
Measurements and simple assertions made about a patient, device or other subject.

# entry[].resource.snapshot.element[].comment
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

# entry[].resource.snapshot.element[].definition
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

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

# entry[].resource.snapshot.element[].isModifierReason
This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation

# entry[].resource.snapshot.element[].short
A set of rules under which this content was created

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The base language in which the resource is written.

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

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

# entry[].resource.snapshot.element[].short
Text summary of the resource, for human interpretation

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

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A unique identifier assigned to this observation.

# entry[].resource.snapshot.element[].mapping[].map
OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4.

# entry[].resource.snapshot.element[].requirements
Allows observations to be distinguished and referenced.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A plan, proposal or order that is fulfilled in whole or in part by this event.  For example, a MedicationRequest may require a patient to have laboratory test performed before  it is dispensed.

# entry[].resource.snapshot.element[].requirements
Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.

# entry[].resource.snapshot.element[].comment
To link an Observation to an Encounter use `encounter`.  See the  [Notes](http://hl7.org/fhir/R4/observation.html#obsgrouping) below for guidance on referencing another Observation.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A larger event of which this particular Observation is a component or step.  For example,  an observation as part of a procedure.

# entry[].resource.snapshot.element[].binding.description
Codes providing the status of an observation.

# entry[].resource.snapshot.element[].comment
This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].isModifierReason
This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid

# entry[].resource.snapshot.element[].mapping[].map
status  Amended & Final are differentiated by whether it is the subject of a ControlAct event with a type of "revise"

# entry[].resource.snapshot.element[].requirements
Need to track the status of individual results. Some results are finalized before the whole report is finalized.

# entry[].resource.snapshot.element[].short
registered | preliminary | final | amended +

# entry[].resource.snapshot.element[].binding.description
Codes for high level observation categories.

# entry[].resource.snapshot.element[].comment
In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A code that classifies the general type of observation being made.

# entry[].resource.snapshot.element[].requirements
Used for filtering what observations are retrieved and displayed.

# entry[].resource.snapshot.element[].binding.description
Codes identifying names of simple observations.

# entry[].resource.snapshot.element[].comment
*All* code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Describes what was observed. Sometimes this is called the observation "name".

# entry[].resource.snapshot.element[].mapping[].map
< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|

# entry[].resource.snapshot.element[].requirements
Knowing what kind of observation is being made is essential to understanding the observation.

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

# entry[].resource.snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# entry[].resource.snapshot.element[].comment
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A reference to a code defined by a terminology system.

# entry[].resource.snapshot.element[].requirements
Allows for alternative encodings within a code system, and translations to other code systems.

# entry[].resource.snapshot.element[].comment
Very often the text is the same as a displayName of one of the codings.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

# entry[].resource.snapshot.element[].mapping[].map
C*E.9. But note many systems use C*E.2 for this

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

# entry[].resource.snapshot.element[].short
Plain text representation of the concept

# entry[].resource.snapshot.element[].comment
One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The patient, or group of patients, location, or device this observation is about and into whose record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the `focus` element or the `code` itself specifies the actual focus of the observation.

# entry[].resource.snapshot.element[].requirements
Observations have no value if you don't know who or what they're about.

# entry[].resource.snapshot.element[].short
Who and/or what the observation is about

# entry[].resource.snapshot.element[].comment
Typically, an observation is made about the subject - a patient, or group of patients, location, or device - and the distinction between the subject and what is directly measured for an observation is specified in the observation code itself ( e.g., "Blood Glucose") and does not need to be represented separately using this element.  Use `specimen` if a reference to a specimen is required.  If a code is required instead of a resource use either  `bodysite` for bodysites or the standard extension [focusCode](http://hl7.org/fhir/R4/extension-observation-focuscode.html).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The actual focus of an observation when it is not the patient of record representing something or someone associated with the patient such as a spouse, parent, fetus, or donor. For example, fetus observations in a mother's record.  The focus of an observation could also be an existing condition,  an intervention, the subject's diet,  another observation of the subject,  or a body structure such as tumor or implanted device.   An example use case would be using the Observation resource to capture whether the mother is trained to change her child's tracheostomy tube. In this example, the child is the patient of record and the mother is the focus.

# entry[].resource.snapshot.element[].short
What the observation is about, when it is not about the subject of record

# entry[].resource.snapshot.element[].comment
This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.

# entry[].resource.snapshot.element[].requirements
For some observations it may be important to know the link between an observation and a particular encounter.

# entry[].resource.snapshot.element[].short
Healthcare event during which this observation is made

# entry[].resource.snapshot.element[].comment
At least a date should be present unless this observation is a historical report.  For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the [Timing](http://hl7.org/fhir/R4/datatypes.html#timing) datatype which allow the measurement to be tied to regular life events.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.

# entry[].resource.snapshot.element[].mapping[].map
OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)

# entry[].resource.snapshot.element[].requirements
Knowing when an observation was deemed true is important to its relevance as well as determining trends.

# entry[].resource.snapshot.element[].comment
For Observations that don’t require review and verification, it may be the same as the [`lastUpdated` ](http://hl7.org/fhir/R4/resource-definitions.html#Meta.lastUpdated) time of the resource itself.  For Observations that do require review and verification for certain updates, it might not be the same as the `lastUpdated` time of the resource itself due to a non-clinically significant update that doesn’t require the new version to be reviewed and verified again.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The date and time this version of the observation was made available to providers, typically after the results have been reviewed and verified.

# entry[].resource.snapshot.element[].mapping[].map
OBR.22 (or MSH.7), or perhaps OBX-19 (depends on who observation made)

# entry[].resource.snapshot.element[].short
Date/Time this version was made available

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Who was responsible for asserting the observed value as "true".

# entry[].resource.snapshot.element[].requirements
May give a degree of confidence in the observation and also indicates where follow-up questions should be directed.

# entry[].resource.snapshot.element[].comment
An observation may have; 1)  a single value here, 2)  both a value and a set of related or component values,  or 3)  only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code.  A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.  For additional guidance, see the [Notes section](http://hl7.org/fhir/R4/observation.html#notes) below.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The information determined as a result of making the observation, if the information has a simple value.

# entry[].resource.snapshot.element[].requirements
An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

# entry[].resource.snapshot.element[].binding.description
Codes specifying why the result (`Observation.value[x]`) is missing.

# entry[].resource.snapshot.element[].comment
Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  "detected", "not detected", "inconclusive", or  "specimen unsatisfactory".   

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Provides a reason why the expected value in the element Observation.value[x] is missing.

# entry[].resource.snapshot.element[].requirements
For many results it is necessary to handle exceptional values in measurements.

# entry[].resource.snapshot.element[].comment
Historically used for laboratory results (known as 'abnormal flag' ),  its use extends to other use cases where coded interpretations  are relevant.  Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A categorical assessment of an observation value.  For example, high, low, normal.

# entry[].resource.snapshot.element[].requirements
For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

# entry[].resource.snapshot.element[].comment
May include general statements about the observation, or statements about significant, unexpected or unreliable results values, or information about its source when relevant to its interpretation.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Comments about the observation or the results.

# entry[].resource.snapshot.element[].mapping[].map
NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)

# entry[].resource.snapshot.element[].requirements
Need to be able to provide free text additional information.

# entry[].resource.snapshot.element[].binding.description
Codes describing anatomical locations. May include laterality.

# entry[].resource.snapshot.element[].comment
Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   

If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ bodySite](http://hl7.org/fhir/R4/extension-bodysite.html).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Indicates the site on the subject's body where the observation was made (i.e. the target site).

# entry[].resource.snapshot.element[].comment
Only used if not implicit in code for Observation.code.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Indicates the mechanism used to perform the observation.

# entry[].resource.snapshot.element[].requirements
In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.

# entry[].resource.snapshot.element[].comment
Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The specimen that was used when this observation was made.

# entry[].resource.snapshot.element[].comment
Note that this is not meant to represent a device involved in the transmission of the result, e.g., a gateway.  Such devices may be documented using the Provenance resource where relevant.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The device used to generate the observation data.

# entry[].resource.snapshot.element[].comment
Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].expression
low.exists() or high.exists() or text.exists()

# entry[].resource.snapshot.element[].constraint[].human
Must have at least a low or a high or text

# entry[].resource.snapshot.element[].definition
Guidance on how to interpret the value by comparison to a normal or recommended range.  Multiple reference ranges are interpreted as an "OR".   In other words, to represent two distinct target populations, two `referenceRange` elements would be used.

# entry[].resource.snapshot.element[].requirements
Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The value of the low bound of the reference range.  The low bound of the reference range endpoint is inclusive of the value (e.g.  reference range is >=5 - <=9). If the low bound is omitted,  it is assumed to be meaningless (e.g. reference range is <=2.3).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The value of the high bound of the reference range.  The high bound of the reference range endpoint is inclusive of the value (e.g.  reference range is >=5 - <=9). If the high bound is omitted,  it is assumed to be meaningless (e.g. reference range is >= 2.3).

# entry[].resource.snapshot.element[].binding.description
Code for the meaning of a reference range.

# entry[].resource.snapshot.element[].comment
This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.

# entry[].resource.snapshot.element[].mapping[].map
< 260245000 |Findings values| OR  
< 365860008 |General clinical state finding| 
OR 
< 250171008 |Clinical history or observation findings| OR  
< 415229000 |Racial group| OR 
< 365400002 |Finding of puberty stage| OR
< 443938003 |Procedure carried out on subject|

# entry[].resource.snapshot.element[].requirements
Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc.,  - for proper interpretation.

# entry[].resource.snapshot.element[].binding.description
Codes identifying the population the reference range applies to.

# entry[].resource.snapshot.element[].comment
This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.  Multiple `appliesTo`  are interpreted as an "AND" of the target populations.  For example, to represent a target population of African American females, both a code of female and a code for African American would be used.

# entry[].resource.snapshot.element[].mapping[].map
< 260245000 |Findings values| OR  
< 365860008 |General clinical state finding| 
OR 
< 250171008 |Clinical history or observation findings| OR  
< 415229000 |Racial group| OR 
< 365400002 |Finding of puberty stage| OR
< 443938003 |Procedure carried out on subject|

# entry[].resource.snapshot.element[].requirements
Need to be able to identify the target population for proper interpretation.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The age at which this reference range is applicable. This is a neonatal age (e.g. number of weeks at term) if the meaning says so.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation.  An example would be a reference value of "Negative" or a list or table of "normals".

# entry[].resource.snapshot.element[].short
Text based reference range in an observation

# entry[].resource.snapshot.element[].comment
When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases.  For a discussion on the ways Observations can assembled in groups together, see [Notes](http://hl7.org/fhir/R4/observation.html#obsgrouping) below.  Note that a system may calculate results from [QuestionnaireResponse](http://hl7.org/fhir/R4/questionnaireresponse.html)  into a final score and represent the score as an Observation.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
This observation is a group observation (e.g. a battery, a panel of tests, a set of vital sign measurements) that includes the target as a member of the group.

# entry[].resource.snapshot.element[].mapping[].map
Relationships established by OBX-4 usage

# entry[].resource.snapshot.element[].short
Related resource that belongs to the Observation group

# entry[].resource.snapshot.element[].comment
All the reference choices that are listed in this element can represent clinical observations and other measurements that may be the source for a derived value.  The most common reference will be another Observation.  For a discussion on the ways Observations can assembled in groups together, see [Notes](http://hl7.org/fhir/R4/observation.html#obsgrouping) below.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image.

# entry[].resource.snapshot.element[].mapping[].map
Relationships established by OBX-4 usage

# entry[].resource.snapshot.element[].short
Related measurements the observation is made from

# entry[].resource.snapshot.element[].comment
For a discussion on the ways Observations can be assembled in groups together see [Notes](http://hl7.org/fhir/R4/observation.html#notes) below.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

# entry[].resource.snapshot.element[].requirements
Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].binding.description
Codes identifying names of simple observations.

# entry[].resource.snapshot.element[].comment
*All* code-value and  component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Describes what was observed. Sometimes this is called the observation "code".

# entry[].resource.snapshot.element[].mapping[].map
< 363787002 |Observable entity| OR 
< 386053000 |Evaluation procedure|

# entry[].resource.snapshot.element[].requirements
Knowing what kind of observation is being made is essential to understanding the observation.

# entry[].resource.snapshot.element[].short
Type of component observation (code / type)

# entry[].resource.snapshot.element[].comment
Used when observation has a set of component observations. An observation may have both a value (e.g. an  Apgar score)  and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.  For additional guidance, see the [Notes section](http://hl7.org/fhir/R4/observation.html#notes) below.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The information determined as a result of making the observation, if the information has a simple value.

# entry[].resource.snapshot.element[].requirements
An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

# entry[].resource.snapshot.element[].binding.description
Codes specifying why the result (`Observation.value[x]`) is missing.

# entry[].resource.snapshot.element[].comment
"Null" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  "detected", "not detected", "inconclusive", or  "test not done". 

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code "error" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Provides a reason why the expected value in the element Observation.component.value[x] is missing.

# entry[].resource.snapshot.element[].requirements
For many results it is necessary to handle exceptional values in measurements.

# entry[].resource.snapshot.element[].comment
Historically used for laboratory results (known as 'abnormal flag' ),  its use extends to other use cases where coded interpretations  are relevant.  Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A categorical assessment of an observation value.  For example, high, low, normal.

# entry[].resource.snapshot.element[].requirements
For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

# entry[].resource.snapshot.element[].comment
Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Guidance on how to interpret the value by comparison to a normal or recommended range.

# entry[].resource.snapshot.element[].requirements
Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

# entry[].resource.snapshot.element[].short
Provides guide for interpretation of component result

# entry[].resource.text.div
Name | Flags | Card. | Type | Description & Constraints
Observation | | 0..* | Observation | Measurements and simple assertions
code | | | |
coding | | 1..* | Coding | Code defined by a terminology system
component | | 1..* | BackboneElement | Component results

Documentation for this format

# entry[].resource.description
An observation containing summary information about a study in it's entirety or one of it's subpopulations.

# entry[].resource.snapshot.element[].comment
Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc.  Other resources are used to provide context for observations such as laboratory reports, etc.

# entry[].resource.snapshot.element[].definition
Measurements and simple assertions made about a patient, device or other subject.

# entry[].resource.snapshot.element[].comment
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

# entry[].resource.snapshot.element[].definition
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

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

# entry[].resource.snapshot.element[].isModifierReason
This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation

# entry[].resource.snapshot.element[].short
A set of rules under which this content was created

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The base language in which the resource is written.

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

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

# entry[].resource.snapshot.element[].short
Text summary of the resource, for human interpretation

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

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A unique identifier assigned to this observation.

# entry[].resource.snapshot.element[].mapping[].map
OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4.

# entry[].resource.snapshot.element[].requirements
Allows observations to be distinguished and referenced.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A plan, proposal or order that is fulfilled in whole or in part by this event.  For example, a MedicationRequest may require a patient to have laboratory test performed before  it is dispensed.

# entry[].resource.snapshot.element[].requirements
Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.

# entry[].resource.snapshot.element[].comment
To link an Observation to an Encounter use `encounter`.  See the  [Notes](http://hl7.org/fhir/R4/observation.html#obsgrouping) below for guidance on referencing another Observation.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A larger event of which this particular Observation is a component or step.  For example,  an observation as part of a procedure.

# entry[].resource.snapshot.element[].binding.description
Codes providing the status of an observation.

# entry[].resource.snapshot.element[].comment
This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].isModifierReason
This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid

# entry[].resource.snapshot.element[].mapping[].map
status  Amended & Final are differentiated by whether it is the subject of a ControlAct event with a type of "revise"

# entry[].resource.snapshot.element[].requirements
Need to track the status of individual results. Some results are finalized before the whole report is finalized.

# entry[].resource.snapshot.element[].short
registered | preliminary | final | amended +

# entry[].resource.snapshot.element[].binding.description
Codes for high level observation categories.

# entry[].resource.snapshot.element[].comment
In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A code that classifies the general type of observation being made.

# entry[].resource.snapshot.element[].requirements
Used for filtering what observations are retrieved and displayed.

# entry[].resource.snapshot.element[].binding.description
Codes identifying names of simple observations.

# entry[].resource.snapshot.element[].comment
*All* code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Describes what was observed. Sometimes this is called the observation "name".

# entry[].resource.snapshot.element[].mapping[].map
< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|

# entry[].resource.snapshot.element[].requirements
Knowing what kind of observation is being made is essential to understanding the observation.

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

# entry[].resource.snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# entry[].resource.snapshot.element[].comment
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A reference to a code defined by a terminology system.

# entry[].resource.snapshot.element[].requirements
Allows for alternative encodings within a code system, and translations to other code systems.

# entry[].resource.snapshot.element[].comment
Very often the text is the same as a displayName of one of the codings.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

# entry[].resource.snapshot.element[].mapping[].map
C*E.9. But note many systems use C*E.2 for this

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

# entry[].resource.snapshot.element[].short
Plain text representation of the concept

# entry[].resource.snapshot.element[].comment
One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The patient, or group of patients, location, or device this observation is about and into whose record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the `focus` element or the `code` itself specifies the actual focus of the observation.

# entry[].resource.snapshot.element[].requirements
Observations have no value if you don't know who or what they're about.

# entry[].resource.snapshot.element[].short
Who and/or what the observation is about

# entry[].resource.snapshot.element[].comment
Typically, an observation is made about the subject - a patient, or group of patients, location, or device - and the distinction between the subject and what is directly measured for an observation is specified in the observation code itself ( e.g., "Blood Glucose") and does not need to be represented separately using this element.  Use `specimen` if a reference to a specimen is required.  If a code is required instead of a resource use either  `bodysite` for bodysites or the standard extension [focusCode](http://hl7.org/fhir/R4/extension-observation-focuscode.html).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The actual focus of an observation when it is not the patient of record representing something or someone associated with the patient such as a spouse, parent, fetus, or donor. For example, fetus observations in a mother's record.  The focus of an observation could also be an existing condition,  an intervention, the subject's diet,  another observation of the subject,  or a body structure such as tumor or implanted device.   An example use case would be using the Observation resource to capture whether the mother is trained to change her child's tracheostomy tube. In this example, the child is the patient of record and the mother is the focus.

# entry[].resource.snapshot.element[].short
What the observation is about, when it is not about the subject of record

# entry[].resource.snapshot.element[].comment
This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.

# entry[].resource.snapshot.element[].requirements
For some observations it may be important to know the link between an observation and a particular encounter.

# entry[].resource.snapshot.element[].short
Healthcare event during which this observation is made

# entry[].resource.snapshot.element[].comment
At least a date should be present unless this observation is a historical report.  For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the [Timing](http://hl7.org/fhir/R4/datatypes.html#timing) datatype which allow the measurement to be tied to regular life events.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.

# entry[].resource.snapshot.element[].mapping[].map
OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)

# entry[].resource.snapshot.element[].requirements
Knowing when an observation was deemed true is important to its relevance as well as determining trends.

# entry[].resource.snapshot.element[].comment
For Observations that don’t require review and verification, it may be the same as the [`lastUpdated` ](http://hl7.org/fhir/R4/resource-definitions.html#Meta.lastUpdated) time of the resource itself.  For Observations that do require review and verification for certain updates, it might not be the same as the `lastUpdated` time of the resource itself due to a non-clinically significant update that doesn’t require the new version to be reviewed and verified again.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The date and time this version of the observation was made available to providers, typically after the results have been reviewed and verified.

# entry[].resource.snapshot.element[].mapping[].map
OBR.22 (or MSH.7), or perhaps OBX-19 (depends on who observation made)

# entry[].resource.snapshot.element[].short
Date/Time this version was made available

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Who was responsible for asserting the observed value as "true".

# entry[].resource.snapshot.element[].requirements
May give a degree of confidence in the observation and also indicates where follow-up questions should be directed.

# entry[].resource.snapshot.element[].comment
An observation may have; 1)  a single value here, 2)  both a value and a set of related or component values,  or 3)  only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code.  A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.  For additional guidance, see the [Notes section](http://hl7.org/fhir/R4/observation.html#notes) below.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The information determined as a result of making the observation, if the information has a simple value.

# entry[].resource.snapshot.element[].requirements
An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

# entry[].resource.snapshot.element[].binding.description
Codes specifying why the result (`Observation.value[x]`) is missing.

# entry[].resource.snapshot.element[].comment
Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  "detected", "not detected", "inconclusive", or  "specimen unsatisfactory".   

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Provides a reason why the expected value in the element Observation.value[x] is missing.

# entry[].resource.snapshot.element[].requirements
For many results it is necessary to handle exceptional values in measurements.

# entry[].resource.snapshot.element[].comment
Historically used for laboratory results (known as 'abnormal flag' ),  its use extends to other use cases where coded interpretations  are relevant.  Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A categorical assessment of an observation value.  For example, high, low, normal.

# entry[].resource.snapshot.element[].requirements
For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

# entry[].resource.snapshot.element[].comment
May include general statements about the observation, or statements about significant, unexpected or unreliable results values, or information about its source when relevant to its interpretation.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Comments about the observation or the results.

# entry[].resource.snapshot.element[].mapping[].map
NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)

# entry[].resource.snapshot.element[].requirements
Need to be able to provide free text additional information.

# entry[].resource.snapshot.element[].binding.description
Codes describing anatomical locations. May include laterality.

# entry[].resource.snapshot.element[].comment
Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   

If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ bodySite](http://hl7.org/fhir/R4/extension-bodysite.html).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Indicates the site on the subject's body where the observation was made (i.e. the target site).

# entry[].resource.snapshot.element[].comment
Only used if not implicit in code for Observation.code.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Indicates the mechanism used to perform the observation.

# entry[].resource.snapshot.element[].requirements
In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.

# entry[].resource.snapshot.element[].comment
Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The specimen that was used when this observation was made.

# entry[].resource.snapshot.element[].comment
Note that this is not meant to represent a device involved in the transmission of the result, e.g., a gateway.  Such devices may be documented using the Provenance resource where relevant.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The device used to generate the observation data.

# entry[].resource.snapshot.element[].comment
Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].expression
low.exists() or high.exists() or text.exists()

# entry[].resource.snapshot.element[].constraint[].human
Must have at least a low or a high or text

# entry[].resource.snapshot.element[].definition
Guidance on how to interpret the value by comparison to a normal or recommended range.  Multiple reference ranges are interpreted as an "OR".   In other words, to represent two distinct target populations, two `referenceRange` elements would be used.

# entry[].resource.snapshot.element[].requirements
Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The value of the low bound of the reference range.  The low bound of the reference range endpoint is inclusive of the value (e.g.  reference range is >=5 - <=9). If the low bound is omitted,  it is assumed to be meaningless (e.g. reference range is <=2.3).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The value of the high bound of the reference range.  The high bound of the reference range endpoint is inclusive of the value (e.g.  reference range is >=5 - <=9). If the high bound is omitted,  it is assumed to be meaningless (e.g. reference range is >= 2.3).

# entry[].resource.snapshot.element[].binding.description
Code for the meaning of a reference range.

# entry[].resource.snapshot.element[].comment
This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.

# entry[].resource.snapshot.element[].mapping[].map
< 260245000 |Findings values| OR  
< 365860008 |General clinical state finding| 
OR 
< 250171008 |Clinical history or observation findings| OR  
< 415229000 |Racial group| OR 
< 365400002 |Finding of puberty stage| OR
< 443938003 |Procedure carried out on subject|

# entry[].resource.snapshot.element[].requirements
Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc.,  - for proper interpretation.

# entry[].resource.snapshot.element[].binding.description
Codes identifying the population the reference range applies to.

# entry[].resource.snapshot.element[].comment
This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.  Multiple `appliesTo`  are interpreted as an "AND" of the target populations.  For example, to represent a target population of African American females, both a code of female and a code for African American would be used.

# entry[].resource.snapshot.element[].mapping[].map
< 260245000 |Findings values| OR  
< 365860008 |General clinical state finding| 
OR 
< 250171008 |Clinical history or observation findings| OR  
< 415229000 |Racial group| OR 
< 365400002 |Finding of puberty stage| OR
< 443938003 |Procedure carried out on subject|

# entry[].resource.snapshot.element[].requirements
Need to be able to identify the target population for proper interpretation.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The age at which this reference range is applicable. This is a neonatal age (e.g. number of weeks at term) if the meaning says so.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation.  An example would be a reference value of "Negative" or a list or table of "normals".

# entry[].resource.snapshot.element[].short
Text based reference range in an observation

# entry[].resource.snapshot.element[].comment
When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases.  For a discussion on the ways Observations can assembled in groups together, see [Notes](http://hl7.org/fhir/R4/observation.html#obsgrouping) below.  Note that a system may calculate results from [QuestionnaireResponse](http://hl7.org/fhir/R4/questionnaireresponse.html)  into a final score and represent the score as an Observation.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
This observation is a group observation (e.g. a battery, a panel of tests, a set of vital sign measurements) that includes the target as a member of the group.

# entry[].resource.snapshot.element[].mapping[].map
Relationships established by OBX-4 usage

# entry[].resource.snapshot.element[].short
Related resource that belongs to the Observation group

# entry[].resource.snapshot.element[].comment
All the reference choices that are listed in this element can represent clinical observations and other measurements that may be the source for a derived value.  The most common reference will be another Observation.  For a discussion on the ways Observations can assembled in groups together, see [Notes](http://hl7.org/fhir/R4/observation.html#obsgrouping) below.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image.

# entry[].resource.snapshot.element[].mapping[].map
Relationships established by OBX-4 usage

# entry[].resource.snapshot.element[].short
Related measurements the observation is made from

# entry[].resource.snapshot.element[].comment
For a discussion on the ways Observations can be assembled in groups together see [Notes](http://hl7.org/fhir/R4/observation.html#notes) below.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

# entry[].resource.snapshot.element[].requirements
Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].binding.description
Codes identifying names of simple observations.

# entry[].resource.snapshot.element[].comment
*All* code-value and  component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Describes what was observed. Sometimes this is called the observation "code".

# entry[].resource.snapshot.element[].mapping[].map
< 363787002 |Observable entity| OR 
< 386053000 |Evaluation procedure|

# entry[].resource.snapshot.element[].requirements
Knowing what kind of observation is being made is essential to understanding the observation.

# entry[].resource.snapshot.element[].short
Type of component observation (code / type)

# entry[].resource.snapshot.element[].comment
Used when observation has a set of component observations. An observation may have both a value (e.g. an  Apgar score)  and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.  For additional guidance, see the [Notes section](http://hl7.org/fhir/R4/observation.html#notes) below.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The information determined as a result of making the observation, if the information has a simple value.

# entry[].resource.snapshot.element[].requirements
An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

# entry[].resource.snapshot.element[].binding.description
Codes specifying why the result (`Observation.value[x]`) is missing.

# entry[].resource.snapshot.element[].comment
"Null" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  "detected", "not detected", "inconclusive", or  "test not done". 

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code "error" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Provides a reason why the expected value in the element Observation.component.value[x] is missing.

# entry[].resource.snapshot.element[].requirements
For many results it is necessary to handle exceptional values in measurements.

# entry[].resource.snapshot.element[].comment
Historically used for laboratory results (known as 'abnormal flag' ),  its use extends to other use cases where coded interpretations  are relevant.  Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A categorical assessment of an observation value.  For example, high, low, normal.

# entry[].resource.snapshot.element[].requirements
For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

# entry[].resource.snapshot.element[].comment
Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Guidance on how to interpret the value by comparison to a normal or recommended range.

# entry[].resource.snapshot.element[].requirements
Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

# entry[].resource.snapshot.element[].short
Provides guide for interpretation of component result

# entry[].resource.text.div
Name | Flags | Card. | Type | Description & Constraints
Observation | | 0..* | Observation | Measurements and simple assertions
code | | | |

coding

0..*

Coding

Code defined by a terminology system
Required Pattern: At least the following

system

1..1

uri

Identity of the terminology system
Fixed Value: https://uts.nlm.nih.gov/uts/umls

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: C0242482

display

1..1

string

Representation defined by the system
Fixed Value: Summary Report

subject | | 0..1 | Reference(NCPI Study Group) | Who and/or what the observation is about
focus | | 1..* | Reference(NCPI Research Study) | What the observation is about, when it is not about the subject of record
component | | 1..* | BackboneElement | Component results

Documentation for this format

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# entry[].resource.snapshot.element[].comment
The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

# entry[].resource.snapshot.element[].definition
Source of the definition for the extension code - a logical name or a URL.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).

# entry[].resource.text.div
Name | Flags | Card. | Type | Description & Constraints
Extension | | 0..* | Extension | Supporting Information
extension | | 0..0 | |
url | | 1..1 | uri | "https://nih-ncpi.github.io/ncpi-fhir-ig/StructureDefinition/supporting-info"
value[x] | | 0..1 | Reference(Resource) | Value of extension

Documentation for this format

# entry[].resource.description
A FHIR Document Reference with an embedded DRS URI. See https://github.com/ga4gh/data-repository-service-schemas.

# entry[].resource.snapshot.element[].comment
Usually, this is used for documents other than those defined by FHIR.

# entry[].resource.snapshot.element[].definition
A reference to a document of any kind for any purpose. Provides metadata about the document so that the document can be discovered and managed. The scope of a document is any seralized object with a mime-type, so includes formal patient centric documents (CDA), cliical notes, scanned paper, and non-patient specific documents like policy text.

# entry[].resource.snapshot.element[].comment
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

# entry[].resource.snapshot.element[].definition
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

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

# entry[].resource.snapshot.element[].isModifierReason
This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation

# entry[].resource.snapshot.element[].short
A set of rules under which this content was created

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The base language in which the resource is written.

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

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

# entry[].resource.snapshot.element[].short
Text summary of the resource, for human interpretation

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

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Document identifier as assigned by the source of the document. This identifier is specific to this version of the document. This unique identifier may be used elsewhere to identify this version of the document.

# entry[].resource.snapshot.element[].requirements
The structure and format of this Id shall be consistent with the specification corresponding to the formatCode attribute. (e.g. for a DICOM standard document a 64-character numeric UID, for an HL7 CDA format a serialization of the CDA Document Id extension and root in the form "oid^extension", where OID is a 64 digits max, and the Id is a 16 UTF-8 char max. If the OID is coded without the extension then the '^' character shall not be included.).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Other identifiers associated with the document, including version independent identifiers.

# entry[].resource.snapshot.element[].comment
This is the status of the DocumentReference object, which might be independent from the docStatus element.

This element is labeled as a modifier because the status contains the codes that mark the document or reference as not currently valid.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].isModifierReason
This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid

# entry[].resource.snapshot.element[].comment
The document that is pointed to might be in various lifecycle states.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].short
preliminary | final | amended | entered-in-error

# entry[].resource.snapshot.element[].comment
Key metadata element describing the document that describes he exact type of document. Helps humans to assess whether the document is of interest when viewing a list of documents.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Specifies the particular kind of document referenced  (e.g. History and Physical, Discharge Summary, Progress Note). This usually equates to the purpose of making the document referenced.

# entry[].resource.snapshot.element[].mapping[].map
ClinicalDocument/code/@code 

The typeCode should be mapped from the ClinicalDocument/code element to a set of document type codes configured in the affinity domain. One suggested coding system to use for typeCode is LOINC, in which case the mapping step can be omitted.

# entry[].resource.snapshot.element[].binding.description
High-level kind of a clinical document at a macro level.

# entry[].resource.snapshot.element[].comment
Key metadata element describing the the category or classification of the document. This is a broader perspective that groups similar documents based on how they would be used. This is a primary key used in searching.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A categorization for the type of document referenced - helps for indexing and searching. This may be implied by or derived from the code specified in the DocumentReference.type.

# entry[].resource.snapshot.element[].mapping[].map
Derived from a mapping of /ClinicalDocument/code/@code to an Affinity Domain specified coded value to use and coding system. Affinity Domains are encouraged to use the appropriate value for Type of Service, based on the LOINC Type of Service (see Page 53 of the LOINC User's Manual). Must be consistent with /ClinicalDocument/code/@code

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Who or what the document is about. The document can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of farm animals, or a set of patients that share a common exposure).

# entry[].resource.snapshot.element[].mapping[].map
PID-3 (No standard way to define a Practitioner or Group subject in HL7 v2 MDM message)

# entry[].resource.snapshot.element[].comment
Referencing/indexing time is used for tracking, organizing versions and searching.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
When the document reference was created.

# entry[].resource.snapshot.element[].short
When this document reference was created

# entry[].resource.snapshot.element[].comment
Not necessarily who did the actual data entry (i.e. typist) or who was the source (informant).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Identifies who is responsible for adding the information to the document.

# entry[].resource.snapshot.element[].mapping[].map
TXA-9 (No standard way to indicate a Device in HL7 v2 MDM message)

# entry[].resource.snapshot.element[].comment
Represents a participant within the author institution who has legally authenticated or attested the document. Legal authentication implies that a document has been signed manually or electronically by the legal Authenticator.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Which person or organization authenticates that this document is valid.

# entry[].resource.snapshot.element[].comment
Identifies the logical organization (software system, vendor, or department) to go to find the current version, where to report issues, etc. This is different from the physical location (URL, disk drive, or server) of the document, which is the technical location of the document, which host may be delegated to the management of some other organization.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Identifies the organization or group who is responsible for ongoing maintenance of and access to the document.

# entry[].resource.snapshot.element[].short
Organization which maintains the document

# entry[].resource.snapshot.element[].comment
This element is labeled as a modifier because documents that append to other documents are incomplete on their own.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Relationships that this document has with other document references that already exist.

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].binding.description
The type of relationship between documents.

# entry[].resource.snapshot.element[].comment
If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The type of relationship that this document has with anther document.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The target document of this relationship.

# entry[].resource.snapshot.element[].comment
What the document is about,  a terse summary of the document.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Human-readable description of the source document.

# entry[].resource.snapshot.element[].requirements
Helps humans to assess whether the document is of interest.

# entry[].resource.snapshot.element[].binding.description
Security Labels from the Healthcare Privacy and Security Classification System.

# entry[].resource.snapshot.element[].comment
The confidentiality codes can carry multiple vocabulary items. HL7 has developed an understanding of security and privacy tags that might be desirable in a Document Sharing environment, called HL7 Healthcare Privacy and Security Classification System (HCS). The following specification is recommended but not mandated, as the vocabulary bindings are an administrative domain responsibility. The use of this method is up to the policy domain such as the XDS Affinity Domain or other Trust Domain where all parties including sender and recipients are trusted to appropriately tag and enforce.   

In the HL7 Healthcare Privacy and Security Classification (HCS) there are code systems specific to Confidentiality, Sensitivity, Integrity, and Handling Caveats. Some values would come from a local vocabulary as they are related to workflow roles and special projects.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A set of Security-Tag codes specifying the level of privacy/security of the Document. Note that DocumentReference.meta.security contains the security labels of the "reference" to the document, while DocumentReference.securityLabel contains a snapshot of the security labels on the document the reference refers to.

# entry[].resource.snapshot.element[].requirements
Use of the Health Care Privacy/Security Classification (HCS) system of security-tag use is recommended.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The document and format referenced. There may be multiple content element repetitions, each with a different format.

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].comment
When providing a summary view (for example with Observation.value[x]) Attachment should be represented with a brief display text such as "Signed Procedure Consent".

# entry[].resource.snapshot.element[].constraint[].human
If the Attachment has data, it SHALL have a contentType

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
attachment.url must start with ^drs://. A drs:// hostname-based URI, as defined in the DRS documentation, that tells clients how to access this object. The intent of this field is to make DRS objects self-contained, and therefore easier for clients to store and pass around.  For example, if you arrive at this DRS JSON by resolving a compact identifier-based DRS URI, the `self_uri` presents you with a hostname and properly encoded DRS ID for use in subsequent `access` endpoint calls.

# entry[].resource.snapshot.element[].definition
For referring to data content defined in other formats.

# entry[].resource.snapshot.element[].comment
Note that while IHE mostly issues URNs for format types, not all documents can be identified by a URI.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
An identifier of the document encoding, structure, and template that the document conforms to beyond the base format indicated in the mimeType.

# entry[].resource.snapshot.element[].mapping[].map
derived from the IHE Profile or Implementation Guide templateID

# entry[].resource.snapshot.element[].comment
These values are primarily added to help with searching for interesting/relevant documents.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The clinical context in which the document was prepared.

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Describes the clinical encounter or type of care that the document content is associated with.

# entry[].resource.snapshot.element[].binding.description
This list of codes represents the main clinical acts being documented.

# entry[].resource.snapshot.element[].comment
An event can further specialize the act inherent in the type, such as  where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more event codes are included, they shall not conflict with the values inherent in the class or type elements as such a conflict would create an ambiguous situation.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
This list of codes represents the main clinical acts, such as a colonoscopy or an appendectomy, being documented. In some cases, the event is inherent in the type Code, such as a "History and Physical Report" in which the procedure being documented is necessarily a "History and Physical" act.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The time period over which the service that is described by the document was provided.

# entry[].resource.snapshot.element[].short
Time of service that is being documented

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The kind of facility where the patient was seen.

# entry[].resource.snapshot.element[].mapping[].map
usually from a mapping to a local ValueSet

# entry[].resource.snapshot.element[].mapping[].map
usually a mapping to a local ValueSet. Must be consistent with /clinicalDocument/code

# entry[].resource.snapshot.element[].binding.description
Additional details about where the content was created (e.g. clinical specialty).

# entry[].resource.snapshot.element[].comment
This element should be based on a coarse classification system for the class of specialty practice. Recommend the use of the classification system for Practice Setting, such as that described by the Subject Matter Domain in LOINC.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
This property may convey specifics about the practice setting where the content was created, often reflecting the clinical specialty.

# entry[].resource.snapshot.element[].mapping[].map
usually from a mapping to a local ValueSet

# entry[].resource.snapshot.element[].mapping[].map
usually from a mapping to a local ValueSet

# entry[].resource.snapshot.element[].requirements
This is an important piece of metadata that providers often rely upon to quickly sort and/or filter out to find specific content.

# entry[].resource.snapshot.element[].short
Additional details about where the content was created (e.g. clinical specialty)

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The Patient Information as known when the document was published. May be a reference to a version specific, or contained.

# entry[].resource.snapshot.element[].comment
May be identifiers or resources that caused the DocumentReference or referenced Document to be created.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Related identifiers or resources associated with the DocumentReference.

# entry[].resource.text.div
Name | Flags | Card. | Type | Description & Constraints
DocumentReference | | 0..* | DocumentReference | A reference to a document
content | | | |
attachment | | 1..1 | DRSAttachment | Content in a format defined elsewhere

Documentation for this format

# entry[].resource.description
A FHIR Document Reference created by an analysis task. Context.related = Task 

# entry[].resource.snapshot.element[].comment
Usually, this is used for documents other than those defined by FHIR.

# entry[].resource.snapshot.element[].definition
A reference to a document of any kind for any purpose. Provides metadata about the document so that the document can be discovered and managed. The scope of a document is any seralized object with a mime-type, so includes formal patient centric documents (CDA), cliical notes, scanned paper, and non-patient specific documents like policy text.

# entry[].resource.snapshot.element[].comment
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

# entry[].resource.snapshot.element[].definition
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

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

# entry[].resource.snapshot.element[].isModifierReason
This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation

# entry[].resource.snapshot.element[].short
A set of rules under which this content was created

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The base language in which the resource is written.

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

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

# entry[].resource.snapshot.element[].short
Text summary of the resource, for human interpretation

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

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Document identifier as assigned by the source of the document. This identifier is specific to this version of the document. This unique identifier may be used elsewhere to identify this version of the document.

# entry[].resource.snapshot.element[].requirements
The structure and format of this Id shall be consistent with the specification corresponding to the formatCode attribute. (e.g. for a DICOM standard document a 64-character numeric UID, for an HL7 CDA format a serialization of the CDA Document Id extension and root in the form "oid^extension", where OID is a 64 digits max, and the Id is a 16 UTF-8 char max. If the OID is coded without the extension then the '^' character shall not be included.).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Other identifiers associated with the document, including version independent identifiers.

# entry[].resource.snapshot.element[].comment
This is the status of the DocumentReference object, which might be independent from the docStatus element.

This element is labeled as a modifier because the status contains the codes that mark the document or reference as not currently valid.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].isModifierReason
This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid

# entry[].resource.snapshot.element[].comment
The document that is pointed to might be in various lifecycle states.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].short
preliminary | final | amended | entered-in-error

# entry[].resource.snapshot.element[].comment
Key metadata element describing the document that describes he exact type of document. Helps humans to assess whether the document is of interest when viewing a list of documents.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Specifies the particular kind of document referenced  (e.g. History and Physical, Discharge Summary, Progress Note). This usually equates to the purpose of making the document referenced.

# entry[].resource.snapshot.element[].mapping[].map
ClinicalDocument/code/@code 

The typeCode should be mapped from the ClinicalDocument/code element to a set of document type codes configured in the affinity domain. One suggested coding system to use for typeCode is LOINC, in which case the mapping step can be omitted.

# entry[].resource.snapshot.element[].binding.description
High-level kind of a clinical document at a macro level.

# entry[].resource.snapshot.element[].comment
Key metadata element describing the the category or classification of the document. This is a broader perspective that groups similar documents based on how they would be used. This is a primary key used in searching.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A categorization for the type of document referenced - helps for indexing and searching. This may be implied by or derived from the code specified in the DocumentReference.type.

# entry[].resource.snapshot.element[].mapping[].map
Derived from a mapping of /ClinicalDocument/code/@code to an Affinity Domain specified coded value to use and coding system. Affinity Domains are encouraged to use the appropriate value for Type of Service, based on the LOINC Type of Service (see Page 53 of the LOINC User's Manual). Must be consistent with /ClinicalDocument/code/@code

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Who or what the document is about. The document can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of farm animals, or a set of patients that share a common exposure).

# entry[].resource.snapshot.element[].mapping[].map
PID-3 (No standard way to define a Practitioner or Group subject in HL7 v2 MDM message)

# entry[].resource.snapshot.element[].comment
Referencing/indexing time is used for tracking, organizing versions and searching.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
When the document reference was created.

# entry[].resource.snapshot.element[].short
When this document reference was created

# entry[].resource.snapshot.element[].comment
Not necessarily who did the actual data entry (i.e. typist) or who was the source (informant).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Identifies who is responsible for adding the information to the document.

# entry[].resource.snapshot.element[].mapping[].map
TXA-9 (No standard way to indicate a Device in HL7 v2 MDM message)

# entry[].resource.snapshot.element[].comment
Represents a participant within the author institution who has legally authenticated or attested the document. Legal authentication implies that a document has been signed manually or electronically by the legal Authenticator.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Which person or organization authenticates that this document is valid.

# entry[].resource.snapshot.element[].comment
Identifies the logical organization (software system, vendor, or department) to go to find the current version, where to report issues, etc. This is different from the physical location (URL, disk drive, or server) of the document, which is the technical location of the document, which host may be delegated to the management of some other organization.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Identifies the organization or group who is responsible for ongoing maintenance of and access to the document.

# entry[].resource.snapshot.element[].short
Organization which maintains the document

# entry[].resource.snapshot.element[].comment
This element is labeled as a modifier because documents that append to other documents are incomplete on their own.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Relationships that this document has with other document references that already exist.

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].binding.description
The type of relationship between documents.

# entry[].resource.snapshot.element[].comment
If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The type of relationship that this document has with anther document.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The target document of this relationship.

# entry[].resource.snapshot.element[].comment
What the document is about,  a terse summary of the document.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Human-readable description of the source document.

# entry[].resource.snapshot.element[].requirements
Helps humans to assess whether the document is of interest.

# entry[].resource.snapshot.element[].binding.description
Security Labels from the Healthcare Privacy and Security Classification System.

# entry[].resource.snapshot.element[].comment
The confidentiality codes can carry multiple vocabulary items. HL7 has developed an understanding of security and privacy tags that might be desirable in a Document Sharing environment, called HL7 Healthcare Privacy and Security Classification System (HCS). The following specification is recommended but not mandated, as the vocabulary bindings are an administrative domain responsibility. The use of this method is up to the policy domain such as the XDS Affinity Domain or other Trust Domain where all parties including sender and recipients are trusted to appropriately tag and enforce.   

In the HL7 Healthcare Privacy and Security Classification (HCS) there are code systems specific to Confidentiality, Sensitivity, Integrity, and Handling Caveats. Some values would come from a local vocabulary as they are related to workflow roles and special projects.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A set of Security-Tag codes specifying the level of privacy/security of the Document. Note that DocumentReference.meta.security contains the security labels of the "reference" to the document, while DocumentReference.securityLabel contains a snapshot of the security labels on the document the reference refers to.

# entry[].resource.snapshot.element[].requirements
Use of the Health Care Privacy/Security Classification (HCS) system of security-tag use is recommended.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The document and format referenced. There may be multiple content element repetitions, each with a different format.

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].comment
When providing a summary view (for example with Observation.value[x]) Attachment should be represented with a brief display text such as "Signed Procedure Consent".

# entry[].resource.snapshot.element[].constraint[].human
If the Attachment has data, it SHALL have a contentType

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
attachment.url must start with ^drs://. A drs:// hostname-based URI, as defined in the DRS documentation, that tells clients how to access this object. The intent of this field is to make DRS objects self-contained, and therefore easier for clients to store and pass around.  For example, if you arrive at this DRS JSON by resolving a compact identifier-based DRS URI, the `self_uri` presents you with a hostname and properly encoded DRS ID for use in subsequent `access` endpoint calls.

# entry[].resource.snapshot.element[].definition
For referring to data content defined in other formats.

# entry[].resource.snapshot.element[].comment
Note that while IHE mostly issues URNs for format types, not all documents can be identified by a URI.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
An identifier of the document encoding, structure, and template that the document conforms to beyond the base format indicated in the mimeType.

# entry[].resource.snapshot.element[].mapping[].map
derived from the IHE Profile or Implementation Guide templateID

# entry[].resource.snapshot.element[].comment
These values are primarily added to help with searching for interesting/relevant documents.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The clinical context in which the document was prepared.

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Describes the clinical encounter or type of care that the document content is associated with.

# entry[].resource.snapshot.element[].binding.description
This list of codes represents the main clinical acts being documented.

# entry[].resource.snapshot.element[].comment
An event can further specialize the act inherent in the type, such as  where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more event codes are included, they shall not conflict with the values inherent in the class or type elements as such a conflict would create an ambiguous situation.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
This list of codes represents the main clinical acts, such as a colonoscopy or an appendectomy, being documented. In some cases, the event is inherent in the type Code, such as a "History and Physical Report" in which the procedure being documented is necessarily a "History and Physical" act.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The time period over which the service that is described by the document was provided.

# entry[].resource.snapshot.element[].short
Time of service that is being documented

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The kind of facility where the patient was seen.

# entry[].resource.snapshot.element[].mapping[].map
usually from a mapping to a local ValueSet

# entry[].resource.snapshot.element[].mapping[].map
usually a mapping to a local ValueSet. Must be consistent with /clinicalDocument/code

# entry[].resource.snapshot.element[].binding.description
Additional details about where the content was created (e.g. clinical specialty).

# entry[].resource.snapshot.element[].comment
This element should be based on a coarse classification system for the class of specialty practice. Recommend the use of the classification system for Practice Setting, such as that described by the Subject Matter Domain in LOINC.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
This property may convey specifics about the practice setting where the content was created, often reflecting the clinical specialty.

# entry[].resource.snapshot.element[].mapping[].map
usually from a mapping to a local ValueSet

# entry[].resource.snapshot.element[].mapping[].map
usually from a mapping to a local ValueSet

# entry[].resource.snapshot.element[].requirements
This is an important piece of metadata that providers often rely upon to quickly sort and/or filter out to find specific content.

# entry[].resource.snapshot.element[].short
Additional details about where the content was created (e.g. clinical specialty)

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The Patient Information as known when the document was published. May be a reference to a version specific, or contained.

# entry[].resource.snapshot.element[].comment
May be identifiers or resources that caused the DocumentReference or referenced Document to be created.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Related identifiers or resources associated with the DocumentReference.

# entry[].resource.text.div
Name | Flags | Card. | Type | Description & Constraints
DocumentReference | | 0..* | DocumentReference | A reference to a document
subject | | 1..1 | Reference(Patient | Practitioner | Group | Device) | Who/what is the subject of the document
custodian | | 1..1 | Reference(Organization) | Organization which maintains the document
content | | | |
attachment | | 1..1 | DRSAttachment | Content in a format defined elsewhere
context | | 1..1 | BackboneElement | Clinical context of document
related | | 0..* | Reference(Task) | Related identifiers or resources

Documentation for this format

# entry[].resource.description
The NCPI Research Study is based upon the core FHIR ResearchStudy resource and shall act as the umbrella under which all study resources can ultimately be found. For the purposes of interoperability, some restrictions have been made to enforce a common mechanism for describing enrollment and provide a simple means for summarizing subject count and consent group membership.

# entry[].resource.snapshot.element[].comment
Need to make sure we encompass public health studies.

# entry[].resource.snapshot.element[].definition
A process where a researcher or organization plans and then executes a series of steps intended to increase the field of healthcare-related knowledge.  This includes studies of safety, efficacy, comparative effectiveness and other information about medications, devices, therapies and other interventional and investigative techniques.  A ResearchStudy involves the gathering of information about human or animal subjects.

# entry[].resource.snapshot.element[].comment
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

# entry[].resource.snapshot.element[].definition
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

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

# entry[].resource.snapshot.element[].isModifierReason
This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation

# entry[].resource.snapshot.element[].short
A set of rules under which this content was created

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The base language in which the resource is written.

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

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

# entry[].resource.snapshot.element[].short
Text summary of the resource, for human interpretation

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

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Identifiers assigned to this research study by the sponsor or other systems.

# entry[].resource.snapshot.element[].mapping[].map
Organization's Unique Protocol ID; Secondary IDs

# entry[].resource.snapshot.element[].mapping[].map
No BRIDG mapping (although there is  DocumentVersion.identifier > StudyProtocolDocumentVersion, this is arguably a different semantic)

# entry[].resource.snapshot.element[].requirements
Allows identification of the research study as it is known by various participating systems and in a way that remains consistent across servers.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A short, descriptive user-friendly label for the study.

# entry[].resource.snapshot.element[].mapping[].map
No BRIDG mapping (although there is  StudyProtocolDocumentVersionPublicTitle this is arguably a different semantic: title of a document vs title of a research study)

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The set of steps expected to be performed as part of the execution of the study.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A larger research study of which this particular study is a component or step.

# entry[].resource.snapshot.element[].requirements
Allows breaking a study into components (e.g. by study site) each with their own PI, status, enrollment, etc.

# entry[].resource.snapshot.element[].binding.description
Codes that convey the current status of the research study.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].isModifierReason
This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid

# entry[].resource.snapshot.element[].short
active | administratively-completed | approved | closed-to-accrual | closed-to-accrual-and-intervention | completed | disapproved | in-review | temporarily-closed-to-accrual | temporarily-closed-to-accrual-and-intervention | withdrawn

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The type of study based upon the intent of the study's activities. A classification of the intent of the study.

# entry[].resource.snapshot.element[].short
treatment | prevention | diagnostic | supportive-care | screening | health-services-research | basic-science | device-feasibility

# entry[].resource.snapshot.element[].binding.description
Codes for the stage in the progression of a therapy from initial experimental use in humans in clinical trials to post-market evaluation.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The stage in the progression of a therapy from initial experimental use in humans in clinical trials to post-market evaluation.

# entry[].resource.snapshot.element[].short
n-a | early-phase-1 | phase-1 | phase-1-phase-2 | phase-2 | phase-2-phase-3 | phase-3 | phase-4

# entry[].resource.snapshot.element[].binding.description
Codes that describe the type of research study.  E.g. Study phase, Interventional/Observational, blinding type, etc.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Codes categorizing the type of study such as investigational vs. observational, type of blinding, type of randomization, safety vs. efficacy, etc.

# entry[].resource.snapshot.element[].mapping[].map
Study Type; Primary Purpose; Interventional Model; Masking; Allocation; study Classification; Observational Study Model; Time Perspective; Biospecimen Retention

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

# entry[].resource.snapshot.element[].slicing.description
Extensions are always sliced by (at least) url

# entry[].resource.snapshot.element[].comment
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A reference to a code defined by a terminology system.

# entry[].resource.snapshot.element[].requirements
Allows for alternative encodings within a code system, and translations to other code systems.

# entry[].resource.snapshot.element[].comment
Very often the text is the same as a displayName of one of the codings.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

# entry[].resource.snapshot.element[].mapping[].map
C*E.9. But note many systems use C*E.2 for this

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

# entry[].resource.snapshot.element[].short
Plain text representation of the concept

# entry[].resource.snapshot.element[].binding.description
Codes for medications, devices and other interventions.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The medication(s), food(s), therapy(ies), device(s) or other concerns or interventions that the study is seeking to gain more information about.

# entry[].resource.snapshot.element[].binding.description
Identification of the condition or diagnosis.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The condition that is the focus of the study.  For example, In a study to examine risk factors for Lupus, might have as an inclusion criterion "healthy volunteer", but the target condition code would be a Lupus SNOMED code.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Contact details to assist a user in learning more about or engaging with the study.

# entry[].resource.snapshot.element[].mapping[].map
Central Contact; Central Contact Backup; Overall Study Officials; Facility Contact & Backup (if Study tied to only one location); Investigators

# entry[].resource.snapshot.element[].mapping[].map
PointOfContact > Project > Research Project > Study > StudyProtocol > StudyProtocolVersion

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Citations, references and other related documents.

# entry[].resource.snapshot.element[].mapping[].map
Citations, Links, Available Study Data/Documents

# entry[].resource.snapshot.element[].binding.description
Words associated with the study that may be useful in discovery.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Key terms to aid in searching for or filtering the study.

# entry[].resource.snapshot.element[].binding.description
Countries and regions within which this artifact is targeted for use.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Indicates a country, state or other region where the study is taking place.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A full description of how the study is being conducted.

# entry[].resource.snapshot.element[].comment
The Group referenced should not generally enumerate specific subjects.  Subjects will be linked to the study using the ResearchSubject resource.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Reference to a Group that defines the criteria for and quantity of subjects participating in the study.  E.g. " 200 female Europeans between the ages of 20 and 45 with early onset diabetes".

# entry[].resource.snapshot.element[].mapping[].map
Enrollment; Number of Groups/Cohorts (= number of "enrollment" instances); Groups (Group/Cohort Label = Group.name; Group/Cohort Description = Group.description); Eligibility (Group criteria)

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Identifies the start date and the expected (or actual, depending on status) end date for the study.

# entry[].resource.snapshot.element[].mapping[].map
Study Start Date (start); Study Completion Date (end)

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
An organization that initiates the investigation and is legally responsible for the study.

# entry[].resource.snapshot.element[].short
Organization that initiates and is legally responsible for the study

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A researcher in a study who oversees multiple aspects of the study, such as concept development, protocol writing, protocol submission for IRB approval, participant recruitment, informed consent, data collection, analysis, interpretation and presentation.

# entry[].resource.snapshot.element[].short
Researcher who oversees multiple aspects of the study

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A facility in which study activities are conducted.

# entry[].resource.snapshot.element[].short
Facility where study activities are conducted

# entry[].resource.snapshot.element[].binding.description
Codes for why the study ended prematurely.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A description and/or code explaining the premature termination of the study.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Comments made about the study by the performer, subject or other participants.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Describes an expected sequence of events for one of the participants of a study.  E.g. Exposure to drug A, wash-out, exposure to drug B, wash-out, follow-up.

# entry[].resource.snapshot.element[].short
Defined path through the study for a subject

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Unique, human-readable label for this arm of the study.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Categorization of study arm, e.g. experimental, active comparator, placebo comparater.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A succinct description of the path through the study that would be followed by a subject adhering to this arm.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A goal that the study is aiming to achieve in terms of a scientific question to be answered by the analysis of data collected during the study.

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Unique, human-readable label for this objective of the study.

# entry[].resource.snapshot.element[].mapping[].map
No BRIDG mapping (BRIDG has a description, but not a name)

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.text.div
Name | Flags | Card. | Type | Description & Constraints
ResearchStudy | | 0..* | ResearchStudy | Investigation to increase healthcare-related patient-independent knowledge
category | | | |

coding

0..*

Coding

Code defined by a terminology system
Required Pattern: At least the following

system

1..1

uri

Identity of the terminology system
Fixed Value: https://nih-ncpi.github.io/ncpi-fhir-ig/CodeSystem/ncpi

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: StudyCohort

display

1..1

string

Representation defined by the system
Fixed Value: Study Cohort

enrollment | | 1..* | Reference(NCPI Study Group) | Inclusion & exclusion criteria

Documentation for this format

# entry[].resource.description
FHIR profile used to describe single variable from the dataset. This resource should be as complete as possible including details such as *description*, *data-type*, *permitted enumerations*, *quantity units*, etc.

# entry[].resource.snapshot.element[].comment
An instance of this resource informs the consumer of a health-related service (such as a lab diagnostic test or panel) about how the observations used or produced by this service will look like.

# entry[].resource.snapshot.element[].definition
Set of definitional characteristics for a kind of observation or measurement produced or consumed by an orderable health care service.

# entry[].resource.snapshot.element[].comment
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

# entry[].resource.snapshot.element[].definition
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

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

# entry[].resource.snapshot.element[].isModifierReason
This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation

# entry[].resource.snapshot.element[].short
A set of rules under which this content was created

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The base language in which the resource is written.

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

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

# entry[].resource.snapshot.element[].short
Text summary of the resource, for human interpretation

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

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].binding.description
Codes for high level observation categories.

# entry[].resource.snapshot.element[].comment
This element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used for one instance of ObservationDefinition. The level of granularity is defined by the category concepts in the value set.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A code that classifies the general type of observation.

# entry[].resource.snapshot.element[].requirements
Used for filtering what kinds of observations are retrieved and displayed.

# entry[].resource.snapshot.element[].binding.description
Codes identifying names of simple observations.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Describes what will be observed. Sometimes this is called the observation "name".

# entry[].resource.snapshot.element[].requirements
Knowing what kind of observation is being made is essential to understanding the observation.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A unique identifier assigned to this ObservationDefinition artifact.

# entry[].resource.snapshot.element[].short
Business identifier for this ObservationDefinition instance

# entry[].resource.snapshot.element[].binding.description
Permitted data type for observation value.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The data types allowed for the value element of the instance observations conforming to this ObservationDefinition.

# entry[].resource.snapshot.element[].short
Quantity | CodeableConcept | string | boolean | integer | Range | Ratio | SampledData | time | dateTime | Period

# entry[].resource.snapshot.element[].comment
An example of observation allowing multiple results is "bacteria identified by culture". Conversely, the measurement of a potassium level allows a single result.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Multiple results allowed for observations conforming to this ObservationDefinition.

# entry[].resource.snapshot.element[].comment
Only used if not implicit in observation code.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The method or technique used to perform the observation.

# entry[].resource.snapshot.element[].requirements
In some cases, method can impact results.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The preferred name to be used when reporting the results of observations conforming to this ObservationDefinition.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Characteristics for quantitative results of this observation.

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Customary unit used to report quantitative results of observations conforming to this ObservationDefinition.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
SI unit used to report quantitative results of observations conforming to this ObservationDefinition.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Factor for converting value expressed with SI unit to value expressed with customary unit.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Number of digits after decimal separator when the results of such observations are of type Quantity.

# entry[].resource.snapshot.element[].short
Decimal precision of observation quantitative results

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Multiple  ranges of results qualified by different contexts for ordinal or continuous observations conforming to this ObservationDefinition.

# entry[].resource.snapshot.element[].short
Qualified range for continuous and ordinal observation results

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].binding.description
Codes identifying the category of observation range.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The category of interval of values for continuous or ordinal observations conforming to this ObservationDefinition.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The low and high values determining the interval. There may be only one of the two.

# entry[].resource.snapshot.element[].requirements
The unit may be not relevant for ordinal values. In case it is there, it is the same as quantitativeDetails.unit.

# entry[].resource.snapshot.element[].short
The interval itself, for continuous or ordinal observations

# entry[].resource.snapshot.element[].binding.description
Code identifying the health context of a range.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Codes to indicate the health context the range applies to. For example, the normal or therapeutic range.

# entry[].resource.snapshot.element[].binding.description
Codes identifying the population the reference range applies to.

# entry[].resource.snapshot.element[].comment
If this element is not present then the global population is assumed.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Codes to indicate the target population this reference range applies to.

# entry[].resource.snapshot.element[].binding.description
The gender of a person used for administrative purposes.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Sex of the population the range applies to.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The age at which this reference range is applicable. This is a neonatal age (e.g. number of weeks at term) if the meaning says so.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The gestational age to which this reference range is applicable, in the context of pregnancy.

# entry[].resource.snapshot.element[].short
Applicable gestational age range, if relevant

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Text based condition for which the reference range is valid.

# entry[].resource.snapshot.element[].short
Condition associated with the reference range

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The set of valid coded results for the observations  conforming to this ObservationDefinition.

# entry[].resource.snapshot.element[].short
Value set of valid coded values for the observations conforming to this ObservationDefinition

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The set of normal coded results for the observations conforming to this ObservationDefinition.

# entry[].resource.snapshot.element[].short
Value set of normal coded values for the observations conforming to this ObservationDefinition

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The set of abnormal coded results for the observation conforming to this ObservationDefinition.

# entry[].resource.snapshot.element[].short
Value set of abnormal coded values for the observations conforming to this ObservationDefinition

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The set of critical coded results for the observation conforming to this ObservationDefinition.

# entry[].resource.snapshot.element[].short
Value set of critical coded values for the observations conforming to this ObservationDefinition

# entry[].resource.text.div
Name | Flags | Card. | Type | Description & Constraints
ObservationDefinition | | 0..* | ObservationDefinition | Definition of an observation

Documentation for this format

# entry[].resource.title
NCPI Study Data Dictionary Data Variable

# entry[].resource.description
Aggregates Variable Details associated with a single dataset table that are represented in FHIR as as list of references to StudyDataDictionaryVariables in the *observationResultRequirement* property.

# entry[].resource.snapshot.element[].definition
This resource allows for the definition of some activity to be performed, independent of a particular patient, practitioner, or other performance context.

# entry[].resource.snapshot.element[].short
The definition of a specific activity to be taken, independent of any particular patient or context

# entry[].resource.snapshot.element[].comment
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

# entry[].resource.snapshot.element[].definition
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

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

# entry[].resource.snapshot.element[].isModifierReason
This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation

# entry[].resource.snapshot.element[].short
A set of rules under which this content was created

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The base language in which the resource is written.

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

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

# entry[].resource.snapshot.element[].short
Text summary of the resource, for human interpretation

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

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].comment
Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred.  Multiple instances may share the same URL if they have a distinct version.

The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author.  Considerations for making this decision are found in [Technical and Business Versions](http://hl7.org/fhir/R4/resource.html#versions). 

In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the [meta.source](http://hl7.org/fhir/R4/resource.html#meta) element to indicate where the current master source of the resource can be found.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
An absolute URI that is used to identify this activity definition when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative instance of this activity definition is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the activity definition is stored on different servers.

# entry[].resource.snapshot.element[].requirements
Allows the activity definition to be referenced by a single globally unique identifier.

# entry[].resource.snapshot.element[].short
Canonical identifier for this activity definition, represented as a URI (globally unique)

# entry[].resource.snapshot.element[].comment
Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this activity definition outside of FHIR, where it is not possible to use the logical URI.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A formal identifier that is used to identify this activity definition when it is represented in other formats, or referenced in a specification, model, design or an instance.

# entry[].resource.snapshot.element[].requirements
Allows externally provided and/or usable business identifiers to be easily associated with the module.

# entry[].resource.snapshot.element[].short
Additional identifier for the activity definition

# entry[].resource.snapshot.element[].comment
There may be different activity definition instances that have the same identifier but different versions.  The version can be appended to the url in a reference to allow a reference to a particular business version of the activity definition with the format [url]|[version].

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The identifier that is used to identify this version of the activity definition when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the activity definition author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence. To provide a version consistent with the Decision Support Service specification, use the format Major.Minor.Revision (e.g. 1.0.0). For more information on versioning knowledge assets, refer to the Decision Support Service specification. Note that a version is required for non-experimental active assets.

# entry[].resource.snapshot.element[].short
Business version of the activity definition

# entry[].resource.snapshot.element[].comment
The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A natural language name identifying the activity definition. This name should be usable as an identifier for the module by machine processing applications such as code generation.

# entry[].resource.snapshot.element[].requirements
Support human navigation and code generation.

# entry[].resource.snapshot.element[].short
Name for this activity definition (computer friendly)

# entry[].resource.snapshot.element[].comment
This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A short, descriptive, user-friendly title for the activity definition.

# entry[].resource.snapshot.element[].short
Name for this activity definition (human friendly)

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
An explanatory or alternate title for the activity definition giving additional information about its content.

# entry[].resource.snapshot.element[].short
Subordinate title of the activity definition

# entry[].resource.snapshot.element[].comment
Allows filtering of activity definitions that are appropriate for use versus not.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The status of this activity definition. Enables tracking the life-cycle of the content.

# entry[].resource.snapshot.element[].isModifierReason
This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration

# entry[].resource.snapshot.element[].comment
Allows filtering of activity definitions that are appropriate for use versus not.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A Boolean value to indicate that this activity definition is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage.

# entry[].resource.snapshot.element[].requirements
Enables experimental content to be developed following the same lifecycle that would be used for a production-level activity definition.

# entry[].resource.snapshot.element[].binding.description
The possible types of subjects for an activity (E.g. Patient, Practitioner, Organization, Location, etc.).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A code or group definition that describes the intended subject of the activity being defined.

# entry[].resource.snapshot.element[].short
Type of individual the activity definition is intended for

# entry[].resource.snapshot.element[].comment
Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the activity definition. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The date  (and optionally time) when the activity definition was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the activity definition changes.

# entry[].resource.snapshot.element[].comment
Usually an organization but may be an individual. The publisher (or steward) of the activity definition is the organization or individual primarily responsible for the maintenance and upkeep of the activity definition. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the activity definition. This item SHOULD be populated unless the information is available from context.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The name of the organization or individual that published the activity definition.

# entry[].resource.snapshot.element[].mapping[].map
Definition.publisher {as string instead of CodeableConcept}

# entry[].resource.snapshot.element[].requirements
Helps establish the "authority/credibility" of the activity definition.  May also allow for contact.

# entry[].resource.snapshot.element[].short
Name of the publisher (organization or individual)

# entry[].resource.snapshot.element[].comment
May be a web site, an email address, a telephone number, etc.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Contact details to assist a user in finding and communicating with the publisher.

# entry[].resource.snapshot.element[].comment
This description can be used to capture details such as why the activity definition was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the activity definition as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the activity definition is presumed to be the predominant language in the place the activity definition was created).

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A free text natural language description of the activity definition from a consumer's perspective.

# entry[].resource.snapshot.element[].short
Natural language description of the activity definition

# entry[].resource.snapshot.element[].comment
When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate activity definition instances.

# entry[].resource.snapshot.element[].requirements
Assist in searching for appropriate content.

# entry[].resource.snapshot.element[].short
The context that the content is intended to support

# entry[].resource.snapshot.element[].binding.description
Countries and regions within which this artifact is targeted for use.

# entry[].resource.snapshot.element[].comment
It may be possible for the activity definition to be used in jurisdictions other than those for which it was originally designed or intended.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A legal or geographic region in which the activity definition is intended to be used.

# entry[].resource.snapshot.element[].short
Intended jurisdiction for activity definition (if applicable)

# entry[].resource.snapshot.element[].comment
This element does not describe the usage of the activity definition. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is.  This may be used to point to source materials or specifications that drove the structure of this activity definition.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Explanation of why this activity definition is needed and why it has been designed as it has.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A detailed description of how the activity definition is used from a clinical perspective.

# entry[].resource.snapshot.element[].short
Describes the clinical usage of the activity definition

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A copyright statement relating to the activity definition and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the activity definition.

# entry[].resource.snapshot.element[].requirements
Consumers must be able to determine any legal restrictions on the use of the activity definition and/or its content.

# entry[].resource.snapshot.element[].comment
The 'date' element may be more recent than the approval date because of minor changes or editorial corrections.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The date on which the resource content was approved by the publisher. Approval happens once when the content is officially approved for usage.

# entry[].resource.snapshot.element[].short
When the activity definition was approved by publisher

# entry[].resource.snapshot.element[].comment
If specified, this date follows the original approval date.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date.

# entry[].resource.snapshot.element[].requirements
Gives a sense of how "current" the content is.  Resources that have not been reviewed in a long time may have a risk of being less appropriate/relevant.

# entry[].resource.snapshot.element[].short
When the activity definition was last reviewed

# entry[].resource.snapshot.element[].comment
The effective period for a activity definition  determines when the content is applicable for usage and is independent of publication and review dates. For example, a measure intended to be used for the year 2016 might be published in 2015.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The period during which the activity definition content was or is planned to be in active use.

# entry[].resource.snapshot.element[].requirements
Allows establishing a transition before a resource comes into effect and also allows for a sunsetting  process when new versions of the activity definition are or are expected to be used instead.

# entry[].resource.snapshot.element[].short
When the activity definition is expected to be used

# entry[].resource.snapshot.element[].binding.description
High-level categorization of the definition, used for searching, sorting, and filtering.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Descriptive topics related to the content of the activity. Topics provide a high-level categorization of the activity that can be useful for filtering and searching.

# entry[].resource.snapshot.element[].requirements
Repositories must be able to determine how to categorize the activity definition so that it can be found by topical searches.

# entry[].resource.snapshot.element[].short
E.g. Education, Treatment, Assessment, etc.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
An individiual or organization primarily involved in the creation and maintenance of the content.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
An individual or organization primarily responsible for internal coherence of the content.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
An individual or organization primarily responsible for review of some aspect of the content.

# entry[].resource.snapshot.element[].mapping[].map
.participation[typeCode=VRF] {not clear whether VRF best corresponds to reviewer or endorser}

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
An individual or organization responsible for officially endorsing the content for use in some setting.

# entry[].resource.snapshot.element[].mapping[].map
.participation[typeCode=VRF] {not clear whether VRF best corresponds to reviewer or endorser}

# entry[].resource.snapshot.element[].comment
Each related artifact is either an attachment, or a reference to another resource, but not both.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Related artifacts such as additional documentation, justification, or bibliographic references.

# entry[].resource.snapshot.element[].mapping[].map
.outboundRelationship[typeCode=DOC,RSON,PREV, DRIV, USE, COMP] {successor would be PREV w/ inversionInd=true; No support for citation}

# entry[].resource.snapshot.element[].requirements
Activity definitions must be able to provide enough information for consumers of the content (and/or interventions or results produced by the content) to be able to determine and understand the justification for and evidence in support of the content.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A reference to a Library resource containing any formal logic used by the activity definition.

# entry[].resource.snapshot.element[].binding.description
The kind of activity the definition is describing.

# entry[].resource.snapshot.element[].comment
May determine what types of extensions are permitted.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A description of the kind of resource the activity definition is representing. For example, a MedicationRequest, a ServiceRequest, or a CommunicationRequest. Typically, but not always, this is a Request resource.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A profile to which the target of the activity definition is expected to conform.

# entry[].resource.snapshot.element[].requirements
Allows profiles to be used to describe the types of activities that can be performed within a workflow, protocol, or order set.

# entry[].resource.snapshot.element[].short
What profile the resource needs to conform to

# entry[].resource.snapshot.element[].binding.description
Detailed type of the activity; e.g. CBC.

# entry[].resource.snapshot.element[].comment
Tends to be less relevant for activities involving particular products.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Detailed description of the type of activity; e.g. What lab test, what procedure, what kind of encounter.

# entry[].resource.snapshot.element[].requirements
Allows matching performed to planned as well as validation against protocols.

# entry[].resource.snapshot.element[].binding.description
Codes indicating the degree of authority/intentionality associated with a request.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Indicates the level of authority/intentionality associated with the activity and where the request should fit into the workflow chain.

# entry[].resource.snapshot.element[].short
proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option

# entry[].resource.snapshot.element[].binding.description
Identifies the level of importance to be assigned to actioning the request.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Indicates how quickly the activity  should be addressed with respect to other requests.

# entry[].resource.snapshot.element[].comment
This element is not intended to be used to communicate a decision support response to cancel an order in progress. That should be done with the "remove" type of a PlanDefinition or RequestGroup.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Set this to true if the definition is to indicate that a particular activity should NOT be performed. If true, this element should be interpreted to reinforce a negative coding. For example NPO as a code with a doNotPerform of true would still indicate to NOT perform the action.

# entry[].resource.snapshot.element[].isModifierReason
If true this element negates the specified action. For Example,  instead of a request for a procedure, it is a request for the procedure to not occur.

# entry[].resource.snapshot.element[].short
True if the activity should not be performed

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The period, timing or frequency upon which the described activity is to occur.

# entry[].resource.snapshot.element[].requirements
Allows prompting for activities and detection of missed planned activities.

# entry[].resource.snapshot.element[].comment
May reference a specific clinical location or may just identify a type of location.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Identifies the facility where the activity will occur; e.g. home, hospital, specific clinic, etc.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Indicates who should participate in performing the action described.

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].binding.description
The type of participant in the activity.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].short
patient | practitioner | related-person | device

# entry[].resource.snapshot.element[].binding.description
Defines roles played by participants for the action.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The role the participant should play in performing the described action.

# entry[].resource.snapshot.element[].binding.description
Code describing the type of substance or medication.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Identifies the food, drug or other product being consumed or supplied in the activity.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Identifies the quantity expected to be consumed at once (per dose, per meal, etc.).

# entry[].resource.snapshot.element[].comment
If a dosage instruction is used, the definition should not specify timing or quantity.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Provides detailed dosage instructions in the same way that they are described for MedicationRequest resources.

# entry[].resource.snapshot.element[].binding.description
A code that identifies the anatomical location.

# entry[].resource.snapshot.element[].comment
Only used if not implicit in the code found in ServiceRequest.type.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Indicates the sites on the subject's body where the procedure should be performed (I.e. the target sites).

# entry[].resource.snapshot.element[].requirements
Knowing where the procedure is made is important for tracking if multiple sites are possible.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Defines specimen requirements for the action to be performed, such as required specimens for a lab test.

# entry[].resource.snapshot.element[].requirements
Needed to represent lab order definitions.

# entry[].resource.snapshot.element[].short
What specimens are required to perform this action

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Defines observation requirements for the action to be performed, such as body weight or surface area.

# entry[].resource.snapshot.element[].requirements
Needed to represent observation definitions.

# entry[].resource.snapshot.element[].short
What observations are required to perform this action

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Defines the observations that are expected to be produced by the action.

# entry[].resource.snapshot.element[].short
What observations must be produced by this action

# entry[].resource.snapshot.element[].comment
Note that if both a transform and dynamic values are specified, the dynamic values will be applied to the result of the transform.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
A reference to a StructureMap resource that defines a transform that can be executed to produce the intent resource using the ActivityDefinition instance as the input.

# entry[].resource.snapshot.element[].comment
Dynamic values are applied in the order in which they are defined in the ActivityDefinition. Note that if both a transform and dynamic values are specified, the dynamic values will be applied to the result of the transform.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
Dynamic values that will be evaluated to produce values for elements of the resulting resource. For example, if the dosage of a medication must be computed based on the patient's weight, a dynamic value would be used to specify an expression that calculated the weight, and the path on the request resource that would contain the result.

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

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

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

# entry[].resource.snapshot.element[].short
Additional content defined by implementations

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

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].constraint[].human
Must have either extensions or value[x], not both

# entry[].resource.snapshot.element[].definition
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

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

# entry[].resource.snapshot.element[].isModifierReason
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

# entry[].resource.snapshot.element[].requirements
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).

# entry[].resource.snapshot.element[].short
Extensions that cannot be ignored even if unrecognized

# entry[].resource.snapshot.element[].comment
The path attribute contains a [Simple FHIRPath Subset](http://hl7.org/fhir/R4/fhirpath.html#simple) that allows path traversal, but not calculation.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
The path to the element to be customized. This is the path on the resource that will hold the result of the calculation defined by the expression. The specified path SHALL be a FHIRPath resolveable on the specified target type of the ActivityDefinition, and SHALL consist only of identifiers, constant indexers, and a restricted subset of functions. The path is allowed to contain qualifiers (.) to traverse sub-elements, as well as indexers ([x]) to traverse multiple-cardinality sub-elements (see the [Simple FHIRPath Profile](http://hl7.org/fhir/R4/fhirpath.html#simple) for full details).

# entry[].resource.snapshot.element[].short
The path to the element to be set dynamically

# entry[].resource.snapshot.element[].comment
The expression may be inlined, or may be a reference to a named expression within a logic library referenced by the library element.

# entry[].resource.snapshot.element[].constraint[].expression
hasValue() or (children().count() > id.count())

# entry[].resource.snapshot.element[].constraint[].human
All FHIR elements must have a @value or children

# entry[].resource.snapshot.element[].definition
An expression specifying the value of the customized element.

# entry[].resource.snapshot.element[].short
An expression that provides the dynamic value for the customization

# entry[].resource.text.div
Name | Flags | Card. | Type | Description & Constraints
ActivityDefinition | | 0..* | ActivityDefinition | The definition of a specific activity to be taken, independent of any particular patient or context
code | | 1..1 | CodeableConcept | Detail type of activity

Documentation for this format