NP Core Implementation Guide
1.0.0 - Release Nepal flag

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

Resource Profile: NP Core Clinical Document Reference

Official URL: http://fhir.digitalhealth.gov.np/core/StructureDefinition/np-core-clinical-documentreference Version: 1.0.0
Active as of 2026-10-14 Computable Name: NPCoreClinicalDocumentReference

Sets minimum expectations for referencing a clinical document (such as a discharge summary, progress note, or referral letter) within the NP Core context.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

NameFlagsCard.TypeDescription & Constraints    Filter: doco
DocumentReference 0..* DocumentReference A reference to a document
DocumentReference.implicitRules This element is a modifier element. This element is included in summaries. 0..1 uri A set of rules under which this content was created
DocumentReference.modifierExtension This element is a modifier element. 0..* Extension Extensions that cannot be ignored
DocumentReference.status This element is a modifier element. This element has obligations and must be supported. This element is included in summaries. 1..1 code current | superseded | entered-in-error
Binding: DocumentReferenceStatus (required): The status of the document reference.
ObligationsActor
SHALL:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.type This element has obligations and must be supported. This element is included in summaries. 1..1 CodeableConcept Kind of document (LOINC if possible)
Binding: Clinical Document Type (extensible)
ObligationsActor
SHALL:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.subject This element has obligations and must be supported. This element is included in summaries. 0..1 Reference(NP Core Patient) Who/what is the subject of the document
ObligationsActor
SHALL:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.author This element has obligations and must be supported. This element is included in summaries. 0..* Reference(NP Core Practitioner | NP Core PractitionerRole) Who and/or what authored the document
ObligationsActor
SHOULD:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.authenticator 0..1 Reference(NP Core Practitioner | NP Core PractitionerRole | NP Core Organization) Who/what authenticated the document
DocumentReference.custodian This element has obligations and must be supported. 0..1 Reference(NP Core Organization | NP Core Health Facility) Organization which maintains the document
ObligationsActor
SHOULD:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.content This element has obligations and must be supported. This element is included in summaries. 1..* BackboneElement Document referenced
ObligationsActor
SHALL:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.content.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
DocumentReference.content.attachment This element has obligations and must be supported. This element is included in summaries. 1..1 Attachment Where to access the document
ObligationsActor
SHALL:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server

doco Documentation for this format
NameNP Core ServerNP Core ConsumerNP Core Creatordoco
DocumentReference
DocumentReference / status
DocumentReference / type
DocumentReference / subject
DocumentReference / author
DocumentReference / custodian
DocumentReference / content
DocumentReference / content / attachment

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
DocumentReference.status Base required DocumentReferenceStatus 📍4.0.1 FHIR Std.
DocumentReference.type Base extensible Clinical Document Type 📦1.0.0 This IG

Constraints

Id Grade Path(s) Description Expression
dom-2 error DocumentReference If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error DocumentReference If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error DocumentReference If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error DocumentReference If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice DocumentReference A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

This structure is derived from DocumentReference

NameFlagsCard.TypeDescription & Constraints    Filter: doco
DocumentReference 0..* DocumentReference A reference to a document
DocumentReference.status This element has obligations and must be supported. 1..1 code current | superseded | entered-in-error
ObligationsActor
SHALL:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.type This element has obligations and must be supported. 1..1 CodeableConcept Kind of document (LOINC if possible)
Binding: Clinical Document Type (extensible)
ObligationsActor
SHALL:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.subject This element has obligations and must be supported. 0..1 Reference(NP Core Patient) Who/what is the subject of the document
ObligationsActor
SHALL:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.authenticator 0..1 Reference(NP Core Practitioner | NP Core PractitionerRole | NP Core Organization) Who/what authenticated the document
DocumentReference.custodian This element has obligations and must be supported. 0..1 Reference(NP Core Organization | NP Core Health Facility) Organization which maintains the document
ObligationsActor
SHOULD:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.content This element has obligations and must be supported. 1..* BackboneElement Document referenced
ObligationsActor
SHALL:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.content.attachment This element has obligations and must be supported. 1..1 Attachment Where to access the document
ObligationsActor
SHALL:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.context
DocumentReference.context.encounter 0..* Reference(NP Core Encounter | EpisodeOfCare) Context of the document content

doco Documentation for this format
NameNP Core ServerNP Core ConsumerNP Core Creatordoco
DocumentReference
DocumentReference / status
DocumentReference / type
DocumentReference / subject
DocumentReference / author
DocumentReference / custodian
DocumentReference / content
DocumentReference / content / attachment

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
DocumentReference.type Base extensible Clinical Document Type 📦1.0.0 This IG
NameFlagsCard.TypeDescription & Constraints    Filter: doco
DocumentReference 0..* DocumentReference A reference to a document
DocumentReference.id This element is included in summaries. 0..1 id Logical id of this artifact
DocumentReference.meta This element is included in summaries. 0..1 Meta Metadata about the resource
DocumentReference.implicitRules This element is a modifier element. This element is included in summaries. 0..1 uri A set of rules under which this content was created
DocumentReference.language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
DocumentReference.text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
DocumentReference.contained 0..* Resource Contained, inline Resources
DocumentReference.extension 0..* Extension Additional content defined by implementations
DocumentReference.modifierExtension This element is a modifier element. 0..* Extension Extensions that cannot be ignored
DocumentReference.masterIdentifier This element is included in summaries. 0..1 Identifier Master Version Specific Identifier
DocumentReference.identifier This element is included in summaries. 0..* Identifier Other identifiers for the document
DocumentReference.status This element is a modifier element. This element has obligations and must be supported. This element is included in summaries. 1..1 code current | superseded | entered-in-error
Binding: DocumentReferenceStatus (required): The status of the document reference.
ObligationsActor
SHALL:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.docStatus This element is included in summaries. 0..1 code preliminary | final | amended | entered-in-error
Binding: CompositionStatus (required): Status of the underlying document.
DocumentReference.type This element has obligations and must be supported. This element is included in summaries. 1..1 CodeableConcept Kind of document (LOINC if possible)
Binding: Clinical Document Type (extensible)
ObligationsActor
SHALL:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.category This element is included in summaries. 0..* CodeableConcept Categorization of document
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
DocumentReference.subject This element has obligations and must be supported. This element is included in summaries. 0..1 Reference(NP Core Patient) Who/what is the subject of the document
ObligationsActor
SHALL:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.date This element is included in summaries. 0..1 instant When this document reference was created
DocumentReference.author This element has obligations and must be supported. This element is included in summaries. 0..* Reference(NP Core Practitioner | NP Core PractitionerRole) Who and/or what authored the document
ObligationsActor
SHOULD:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.authenticator 0..1 Reference(NP Core Practitioner | NP Core PractitionerRole | NP Core Organization) Who/what authenticated the document
DocumentReference.custodian This element has obligations and must be supported. 0..1 Reference(NP Core Organization | NP Core Health Facility) Organization which maintains the document
ObligationsActor
SHOULD:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.relatesTo This element is included in summaries. 0..* BackboneElement Relationships to other documents
DocumentReference.relatesTo.id 0..1 string Unique id for inter-element referencing
DocumentReference.relatesTo.extension 0..* Extension Additional content defined by implementations
DocumentReference.relatesTo.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
DocumentReference.relatesTo.code This element is included in summaries. 1..1 code replaces | transforms | signs | appends
Binding: DocumentRelationshipType (required): The type of relationship between documents.
DocumentReference.relatesTo.target This element is included in summaries. 1..1 Reference(DocumentReference) Target of the relationship
DocumentReference.description This element is included in summaries. 0..1 string Human-readable description
DocumentReference.securityLabel This element is included in summaries. 0..* CodeableConcept Document security-tags
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
DocumentReference.content This element has obligations and must be supported. This element is included in summaries. 1..* BackboneElement Document referenced
ObligationsActor
SHALL:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.content.id 0..1 string Unique id for inter-element referencing
DocumentReference.content.extension 0..* Extension Additional content defined by implementations
DocumentReference.content.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
DocumentReference.content.attachment This element has obligations and must be supported. This element is included in summaries. 1..1 Attachment Where to access the document
ObligationsActor
SHALL:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.content.format This element is included in summaries. 0..1 Coding Format/content rules for the document
Binding: DocumentReferenceFormatCodeSet (preferred): Document Format Codes.
DocumentReference.context This element is included in summaries. 0..1 BackboneElement Clinical context of document
DocumentReference.context.id 0..1 string Unique id for inter-element referencing
DocumentReference.context.extension 0..* Extension Additional content defined by implementations
DocumentReference.context.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
DocumentReference.context.encounter 0..* Reference(NP Core Encounter | EpisodeOfCare) Context of the document content
DocumentReference.context.event 0..* CodeableConcept Main clinical acts documented
Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.
DocumentReference.context.period This element is included in summaries. 0..1 Period Time of service that is being documented
DocumentReference.context.facilityType 0..1 CodeableConcept Kind of facility where patient was seen
Binding: FacilityTypeCodeValueSet (example): XDS Facility Type.
DocumentReference.context.practiceSetting 0..1 CodeableConcept Additional details about where the content was created (e.g. clinical specialty)
Binding: PracticeSettingCodeValueSet (example): Additional details about where the content was created (e.g. clinical specialty).
DocumentReference.context.sourcePatientInfo 0..1 Reference(Patient) Patient demographics from source
DocumentReference.context.related 0..* Reference(Resource) Related identifiers or resources

doco Documentation for this format
NameNP Core ServerNP Core ConsumerNP Core Creatordoco
DocumentReference
DocumentReference / status
DocumentReference / type
DocumentReference / subject
DocumentReference / author
DocumentReference / custodian
DocumentReference / content
DocumentReference / content / attachment

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
DocumentReference.language Base preferred Common Languages 📍4.0.1 FHIR Std.
DocumentReference.status Base required DocumentReferenceStatus 📍4.0.1 FHIR Std.
DocumentReference.docStatus Base required CompositionStatus 📍4.0.1 FHIR Std.
DocumentReference.type Base extensible Clinical Document Type 📦1.0.0 This IG
DocumentReference.category Base example Document Class Value Set 📍4.0.1 FHIR Std.
DocumentReference.relatesTo.​code Base required DocumentRelationshipType 📍4.0.1 FHIR Std.
DocumentReference.securityLabel Base extensible SecurityLabels 📍4.0.1 FHIR Std.
DocumentReference.content.​format Base preferred DocumentReference Format Code Set 📍4.0.1 FHIR Std.
DocumentReference.context.​event Base example v3 Code System ActCode 📦3.0.0 THO v7.4
DocumentReference.context.​facilityType Base example Facility Type Code Value Set 📍4.0.1 FHIR Std.
DocumentReference.context.​practiceSetting Base example Practice Setting Code Value Set 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error DocumentReference If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error DocumentReference If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error DocumentReference If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error DocumentReference If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice DocumentReference A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
NameNP Core ServerNP Core ConsumerNP Core Creatordoco
DocumentReference
DocumentReference / status
DocumentReference / type
DocumentReference / subject
DocumentReference / author
DocumentReference / custodian
DocumentReference / content
DocumentReference / content / attachment

doco Documentation for this format

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: doco
DocumentReference 0..* DocumentReference A reference to a document
DocumentReference.implicitRules This element is a modifier element. This element is included in summaries. 0..1 uri A set of rules under which this content was created
DocumentReference.modifierExtension This element is a modifier element. 0..* Extension Extensions that cannot be ignored
DocumentReference.status This element is a modifier element. This element has obligations and must be supported. This element is included in summaries. 1..1 code current | superseded | entered-in-error
Binding: DocumentReferenceStatus (required): The status of the document reference.
ObligationsActor
SHALL:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.type This element has obligations and must be supported. This element is included in summaries. 1..1 CodeableConcept Kind of document (LOINC if possible)
Binding: Clinical Document Type (extensible)
ObligationsActor
SHALL:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.subject This element has obligations and must be supported. This element is included in summaries. 0..1 Reference(NP Core Patient) Who/what is the subject of the document
ObligationsActor
SHALL:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.author This element has obligations and must be supported. This element is included in summaries. 0..* Reference(NP Core Practitioner | NP Core PractitionerRole) Who and/or what authored the document
ObligationsActor
SHOULD:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.authenticator 0..1 Reference(NP Core Practitioner | NP Core PractitionerRole | NP Core Organization) Who/what authenticated the document
DocumentReference.custodian This element has obligations and must be supported. 0..1 Reference(NP Core Organization | NP Core Health Facility) Organization which maintains the document
ObligationsActor
SHOULD:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.content This element has obligations and must be supported. This element is included in summaries. 1..* BackboneElement Document referenced
ObligationsActor
SHALL:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.content.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
DocumentReference.content.attachment This element has obligations and must be supported. This element is included in summaries. 1..1 Attachment Where to access the document
ObligationsActor
SHALL:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server

doco Documentation for this format
NameNP Core ServerNP Core ConsumerNP Core Creatordoco
DocumentReference
DocumentReference / status
DocumentReference / type
DocumentReference / subject
DocumentReference / author
DocumentReference / custodian
DocumentReference / content
DocumentReference / content / attachment

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
DocumentReference.status Base required DocumentReferenceStatus 📍4.0.1 FHIR Std.
DocumentReference.type Base extensible Clinical Document Type 📦1.0.0 This IG

Constraints

Id Grade Path(s) Description Expression
dom-2 error DocumentReference If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error DocumentReference If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error DocumentReference If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error DocumentReference If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice DocumentReference A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

Differential View

This structure is derived from DocumentReference

NameFlagsCard.TypeDescription & Constraints    Filter: doco
DocumentReference 0..* DocumentReference A reference to a document
DocumentReference.status This element has obligations and must be supported. 1..1 code current | superseded | entered-in-error
ObligationsActor
SHALL:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.type This element has obligations and must be supported. 1..1 CodeableConcept Kind of document (LOINC if possible)
Binding: Clinical Document Type (extensible)
ObligationsActor
SHALL:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.subject This element has obligations and must be supported. 0..1 Reference(NP Core Patient) Who/what is the subject of the document
ObligationsActor
SHALL:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.author This element has obligations and must be supported. 0..* Reference(NP Core Practitioner | NP Core PractitionerRole) Who and/or what authored the document
ObligationsActor
SHOULD:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.authenticator 0..1 Reference(NP Core Practitioner | NP Core PractitionerRole | NP Core Organization) Who/what authenticated the document
DocumentReference.custodian This element has obligations and must be supported. 0..1 Reference(NP Core Organization | NP Core Health Facility) Organization which maintains the document
ObligationsActor
SHOULD:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.content This element has obligations and must be supported. 1..* BackboneElement Document referenced
ObligationsActor
SHALL:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.content.attachment This element has obligations and must be supported. 1..1 Attachment Where to access the document
ObligationsActor
SHALL:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.context
DocumentReference.context.encounter 0..* Reference(NP Core Encounter | EpisodeOfCare) Context of the document content

doco Documentation for this format
NameNP Core ServerNP Core ConsumerNP Core Creatordoco
DocumentReference
DocumentReference / status
DocumentReference / type
DocumentReference / subject
DocumentReference / author
DocumentReference / custodian
DocumentReference / content
DocumentReference / content / attachment

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
DocumentReference.type Base extensible Clinical Document Type 📦1.0.0 This IG

Snapshot ViewView

NameFlagsCard.TypeDescription & Constraints    Filter: doco
DocumentReference 0..* DocumentReference A reference to a document
DocumentReference.id This element is included in summaries. 0..1 id Logical id of this artifact
DocumentReference.meta This element is included in summaries. 0..1 Meta Metadata about the resource
DocumentReference.implicitRules This element is a modifier element. This element is included in summaries. 0..1 uri A set of rules under which this content was created
DocumentReference.language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
DocumentReference.text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
DocumentReference.contained 0..* Resource Contained, inline Resources
DocumentReference.extension 0..* Extension Additional content defined by implementations
DocumentReference.modifierExtension This element is a modifier element. 0..* Extension Extensions that cannot be ignored
DocumentReference.masterIdentifier This element is included in summaries. 0..1 Identifier Master Version Specific Identifier
DocumentReference.identifier This element is included in summaries. 0..* Identifier Other identifiers for the document
DocumentReference.status This element is a modifier element. This element has obligations and must be supported. This element is included in summaries. 1..1 code current | superseded | entered-in-error
Binding: DocumentReferenceStatus (required): The status of the document reference.
ObligationsActor
SHALL:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.docStatus This element is included in summaries. 0..1 code preliminary | final | amended | entered-in-error
Binding: CompositionStatus (required): Status of the underlying document.
DocumentReference.type This element has obligations and must be supported. This element is included in summaries. 1..1 CodeableConcept Kind of document (LOINC if possible)
Binding: Clinical Document Type (extensible)
ObligationsActor
SHALL:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.category This element is included in summaries. 0..* CodeableConcept Categorization of document
Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
DocumentReference.subject This element has obligations and must be supported. This element is included in summaries. 0..1 Reference(NP Core Patient) Who/what is the subject of the document
ObligationsActor
SHALL:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.date This element is included in summaries. 0..1 instant When this document reference was created
DocumentReference.author This element has obligations and must be supported. This element is included in summaries. 0..* Reference(NP Core Practitioner | NP Core PractitionerRole) Who and/or what authored the document
ObligationsActor
SHOULD:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.authenticator 0..1 Reference(NP Core Practitioner | NP Core PractitionerRole | NP Core Organization) Who/what authenticated the document
DocumentReference.custodian This element has obligations and must be supported. 0..1 Reference(NP Core Organization | NP Core Health Facility) Organization which maintains the document
ObligationsActor
SHOULD:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.relatesTo This element is included in summaries. 0..* BackboneElement Relationships to other documents
DocumentReference.relatesTo.id 0..1 string Unique id for inter-element referencing
DocumentReference.relatesTo.extension 0..* Extension Additional content defined by implementations
DocumentReference.relatesTo.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
DocumentReference.relatesTo.code This element is included in summaries. 1..1 code replaces | transforms | signs | appends
Binding: DocumentRelationshipType (required): The type of relationship between documents.
DocumentReference.relatesTo.target This element is included in summaries. 1..1 Reference(DocumentReference) Target of the relationship
DocumentReference.description This element is included in summaries. 0..1 string Human-readable description
DocumentReference.securityLabel This element is included in summaries. 0..* CodeableConcept Document security-tags
Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
DocumentReference.content This element has obligations and must be supported. This element is included in summaries. 1..* BackboneElement Document referenced
ObligationsActor
SHALL:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.content.id 0..1 string Unique id for inter-element referencing
DocumentReference.content.extension 0..* Extension Additional content defined by implementations
DocumentReference.content.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
DocumentReference.content.attachment This element has obligations and must be supported. This element is included in summaries. 1..1 Attachment Where to access the document
ObligationsActor
SHALL:able-to-populate NP Core Creator
SHALL:handle NP Core Consumer
SHALL:handle NP Core Server
DocumentReference.content.format This element is included in summaries. 0..1 Coding Format/content rules for the document
Binding: DocumentReferenceFormatCodeSet (preferred): Document Format Codes.
DocumentReference.context This element is included in summaries. 0..1 BackboneElement Clinical context of document
DocumentReference.context.id 0..1 string Unique id for inter-element referencing
DocumentReference.context.extension 0..* Extension Additional content defined by implementations
DocumentReference.context.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
DocumentReference.context.encounter 0..* Reference(NP Core Encounter | EpisodeOfCare) Context of the document content
DocumentReference.context.event 0..* CodeableConcept Main clinical acts documented
Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.
DocumentReference.context.period This element is included in summaries. 0..1 Period Time of service that is being documented
DocumentReference.context.facilityType 0..1 CodeableConcept Kind of facility where patient was seen
Binding: FacilityTypeCodeValueSet (example): XDS Facility Type.
DocumentReference.context.practiceSetting 0..1 CodeableConcept Additional details about where the content was created (e.g. clinical specialty)
Binding: PracticeSettingCodeValueSet (example): Additional details about where the content was created (e.g. clinical specialty).
DocumentReference.context.sourcePatientInfo 0..1 Reference(Patient) Patient demographics from source
DocumentReference.context.related 0..* Reference(Resource) Related identifiers or resources

doco Documentation for this format
NameNP Core ServerNP Core ConsumerNP Core Creatordoco
DocumentReference
DocumentReference / status
DocumentReference / type
DocumentReference / subject
DocumentReference / author
DocumentReference / custodian
DocumentReference / content
DocumentReference / content / attachment

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
DocumentReference.language Base preferred Common Languages 📍4.0.1 FHIR Std.
DocumentReference.status Base required DocumentReferenceStatus 📍4.0.1 FHIR Std.
DocumentReference.docStatus Base required CompositionStatus 📍4.0.1 FHIR Std.
DocumentReference.type Base extensible Clinical Document Type 📦1.0.0 This IG
DocumentReference.category Base example Document Class Value Set 📍4.0.1 FHIR Std.
DocumentReference.relatesTo.​code Base required DocumentRelationshipType 📍4.0.1 FHIR Std.
DocumentReference.securityLabel Base extensible SecurityLabels 📍4.0.1 FHIR Std.
DocumentReference.content.​format Base preferred DocumentReference Format Code Set 📍4.0.1 FHIR Std.
DocumentReference.context.​event Base example v3 Code System ActCode 📦3.0.0 THO v7.4
DocumentReference.context.​facilityType Base example Facility Type Code Value Set 📍4.0.1 FHIR Std.
DocumentReference.context.​practiceSetting Base example Practice Setting Code Value Set 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error DocumentReference If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error DocumentReference If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error DocumentReference If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error DocumentReference If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice DocumentReference A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
NameNP Core ServerNP Core ConsumerNP Core Creatordoco
DocumentReference
DocumentReference / status
DocumentReference / type
DocumentReference / subject
DocumentReference / author
DocumentReference / custodian
DocumentReference / content
DocumentReference / content / attachment

doco Documentation for this format

 

Other representations of profile: CSV, Excel, Schematron